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Treatment & Research Information
New Therapy for Chronic Fatigue Syndrome to Be Tested
at Stanford –
Stanford, Calif. January 8, 2007 -
preliminary study suggests there may be hope in the offing for some
sufferers of Chronic Fatigue Syndrome with a new therapy being tested
by researchers at the Stanford University School of Medicine.
Jose Montoya, MD, associate professor of medicine (infectious diseases),
and postdoctoral scholar Andreas Kogelnik, MD, PhD, have used the drug
valganciclovir - an antiviral often used in treating diseases caused
by human herpes viruses - to treat a small number of CFS patients.
The researchers said they treated 25 patients during the last three
years, 21 of whom responded with significant improvement that was sustained
even after going off the medication at the end of the treatment regimen,
which usually lasts six months. The first patient has now been off the
drug for almost three years and has had no relapses. A paper describing
the first dozen patients Drs. Montoya and Kogelnik treated with the
drug was published in the December issue of the Journal of Clinical
"This study is small and preliminary, but potentially very important,"
said Anthony Komaroff, MD, professor of medicine at Harvard Medical
School, who was not involved in the study. "If a randomized trial
confirmed the value of this therapy for patients like the ones studied
here, it would be an important landmark in the treatment of this illness."
Dr. Montoya has received a $1.3 million grant from Roche Pharmaceutical,
which manufactures the drug under the brand name Valcyte®, to conduct
a randomized, placebo-controlled, double-blind study set to begin this
quarter at Stanford. The study will assess the effectiveness of the
drug in treating a subset of CFS patients.
Dr. Montoya [spoke] about his efforts at the International Association
for Chronic Fatigue Syndrome Conference in Fort Lauderdale on January
11 and 12.
….Valganciclovir is normally used against diseases caused by viruses
in the herpes family, including cytomegalovirus, Epstein-Barr virus
and human herpes virus-6. These diseases usually affect patients whose
immune systems are severely weakened, such as transplant and cancer
patients. Dr. Montoya, who had used the drug in treating such patients
for years, decided to try using it on a CFS patient who came to him
in early 2004 with extremely high levels of antibodies for three of
the herpes family viruses in her blood. At the time, she had been suffering
from CFS for five years.
When a virus infects someone, the levels of antibodies cranked out by
the immune system in response typically increase until the virus is
overcome, then slowly diminish over time. But Dr. Montoya's patient
had persistently high antibodies for the three viruses. In addition,
the lymph nodes in her neck were significantly enlarged, some up to
eight times their normal size, suggesting her immune system was fighting
some kind of infection, even though a comprehensive evaluation had failed
to point to any infectious cause.
Concerned about the unusual elevations in antibody levels as well as
the swelling of her lymph nodes, Montoya decided to prescribe valganciclovir.
"I thought by giving an antiviral that was effective against herpes
viruses for a relatively long period of time, perhaps we could impact
somehow the inflammation that she had in her lymph nodes," said
Within four weeks, the patient's lymph nodes began shrinking. Six weeks
later she phoned Montoya from her home in South America, describing
how she was now exercising, bicycling and going back to work at the
company she ran before her illness. "We were really shocked by
this," recalled Montoya.
Of the two dozen patients Drs. Montoya and Kogelnik have since treated,
the 20 who responded all had developed CFS after an initial flulike
illness, while the non-responders had suffered no initial flu.
Some of the patients take the drug for more than six months, such as
Michael Manson, whose battle with CFS has lasted more than 18 years.
The former triathlete was stricken with a viral infection a year after
his marriage. After trying unsuccessfully to overcome what he thought
were lingering effects of the flu, he had no choice but to drastically
curtail all his activities and eventually stop working.
During his longest period of extreme fatigue, 13-1/2 weeks, Manson said,
"My wife literally thought I was passing away. I could hear the
emotion in her voice as she tried to wake me, but I couldn't wake up
to console her. That was just maddening." Now in his seventh month
of treatment, Manson is able to go backpacking with his children with
no ill after-effects. Prior to starting the treatment, Manson's three
children, ages 9 to 14, had never seen him healthy.
Drs. Montoya and Kogelnik emphasized that even if their new clinical
trial validates the use of valganciclovir in treating some CFS patients,
the drug may not be effective in all cases. In fact, the trial will
assess the effectiveness of the medication among a specific subset of
CFS patients; namely, those who have viral-induced dysfunction of the
central nervous system.
"This could be a solution for a subset of patients, but that subset
could be quite large," said Kristin Loomis, executive director
of the HHV-6 Foundation, which has helped fund a significant portion
of the preparatory work for the clinical trial. "These viruses
have been suspected in CFS for decades, but researchers couldn't prove
it because they are so difficult to detect in the blood. If Dr. Montoya's
results are confirmed, he will have made a real breakthrough."
"What is desperately needed is the completion of the randomized,
double-blind, placebo-controlled clinical trial that we are about to
embark on," Dr. Montoya said.
For Patients Interested in Participating
People interested in participating in the clinical trial must live in
the San Francisco Bay Area. To find more information about the trial,
about the process for applying, and tests that will be required as part
of the application, go to the Virus Induced CNS Dysfunction site –
created by The HHV-6 Foundation, which is a funder of the project –
Also visit the HHV-6 Foundation’s own site at for more background
on the association of HHV-6 with CFS
* An abstract of the article, “Use of valganciclovir in patients
with elevated antibody titers against Human Herpesvirus-6 (HHV-6) and
Epstein-Barr Virus (EBV) who were experiencing central nervous system
dysfunction including long-standing fatigue,” is featured in this
issue. Full text can be downloaded for a fee at http://www.sciencedirect.com/science/journal/13866532
Note: This information is not intended to prevent, diagnose, treat or
cure any illness, condition, or disease. It is essential that you never
make a change in your health support plan or regime without first researching
and reviewing it collaboratively with your professional healthcare team.©2007
ProHealth, Inc. Copyright Policy
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