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Why do some ME/CFS patients benefit from treatment with sodium dichloroacetate, but others do not?

Frank Comhaire1

  • 1Gent University, Belgium.

Medical Hypotheses
|September 18, 2018
PubMed

Insights

Researchers identified six pre-treatment characteristics to predict which Myalgic Encephalencephalopathy/Chronic Fatigue Syndrome (ME/CFS) patients respond to sodium dichloroacetate (DCA) treatment. This may help personalize ME/CFS therapy by identifying suitable candidates for DCA.

Area of Science:

  • Biochemistry
  • Immunology
  • Neuroscience

Background:

  • Myalgic Encephalopathy/Chronic Fatigue Syndrome (ME/CFS) pathogenesis remains unclear.
  • Sodium dichloroacetate (DCA) shows variable efficacy in ME/CFS patients.
  • DCA enhances mitochondrial pyruvate dehydrogenase activity.

Purpose of the Study:

  • To identify predictors of response to sodium dichloroacetate (DCA) in ME/CFS patients.
  • To differentiate between ME/CFS patients who respond and those who do not respond to DCA.
  • To develop a predictive model for DCA treatment suitability in ME/CFS.

Main Methods:

  • Prospective trial involving 35 ME/CFS patients.
  • Logistic regression analysis with stepwise elimination.
  • Receiver Operating Characteristic (ROC) curve analysis to assess predictive accuracy.

Main Results:

  • Six pre-treatment characteristics accurately differentiated responders from non-responders (P < 0.0001, AUC = 0.92).
  • A predictive formula was derived to estimate the probability of treatment response.
  • 13 patients responded to DCA, while 22 did not.

Conclusions:

  • Pre-treatment characteristics can predict DCA response in ME/CFS patients.
  • The derived formula may aid in selecting appropriate candidates for DCA therapy.
  • Further studies are needed to validate the predictive capacity of the formula for ME/CFS treatment.
Keywords:
Chronic fatigue syndromeLogistic regression analysisME/CFS treatmentMyalgic encephalomyelitisMyalgic encephalopathySodium dichloroacetateSystemic immune disorder

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