Friday, November 15, 2013

Results of treatment of 741 Italian patients

Eur Rev Med Pharmacol Sci 2013; 17 (21): 2847-2852
Treatment of 741 italian patients with chronic fatigue syndrome
U. Tirelli, A. Lleshi, M. Berretta, M. Spina, R. Talamini, A. Giacalone

Department of Medical Oncology, Division of Medical Oncology A,
National Cancer Institute of Aviano, Pordenone, Italy. [email protected]

BACKGROUND: Chronic Fatigue Syndrome (CFS) is a distinctive syndrome
characterized by specific symptoms cluster. CFS mostly affects women
and often results in severe functional limitation. Its prevalence
varies from 0.4 to 2.5% in the general population. In our prior
studies on the clinical features of 205 CFS patients we founded
immunological and brain abnormalities. In this paper we illustrate our
caseload on CFS treatment.

PATIENTS AND METHODS: From January 2000 to December 2005, we evaluated
all the patients admitted at the CFS Unit of the Aviano National
Cancer Institute, for staging procedures and treatments. Patients not
meeting the Fukuda diagnostic criteria were excluded.

RESULTS: 250 male and 491 female (median age 35.5 and 39.3 years,
respectively) were enrolled and treated for CFS. As expected, CFS
resulted from previous infectious disease in all patients.
patients showed to be more affected by symptoms than male patients.
The treatment schedules followed by the patients included nutritional supplements alone, corticosteroids, antidepressant/sedative drugs, and antiviral/immunoglobulin drugs. Antiviral/ immunoglobulin drugs achieved the best response (15.3% positive responses vs. 8.3% negative
responses; OR 0.44, CI 0.26-0.74, p = 0.002). The carrying out of 4 or
more treatments showed a protective effect (OR 0.46, CI 0.28-0.77, p =
0.003). This finding was confirmed in the multivariate analysis,
adjusted by type of drugs (OR 0.49, CI 0.28-0.84, p = 0.009) and
number of treatments carried out (OR 0.51, CI 0.30-0.86, p = 0.01);
these two variables were independent.

CONCLUSIONS: These findings show that the antiviral/immunoglobulin
approach has a longer positive disease free survival in comparison
with other approaches.
However, CSF still remains a difficult disease
to be effectively treated.

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