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I think he lurks systematically. If I post anything spiky I get an email from David within the hour more often than not.

Dear Jenny, It is important to remember that the official result from the previous study, in terms of the primary endpoint, was also negative. The apparent difference at six months was interesting enough to justify a further trial but I do not think this result has come as a big surprise to any...

I am no longer involved but I do not think further trials of rituximab will be justified. We have a clear negative result.

As far as I can see this is a bit of humbug. All this started with the mainstream journals doing much the same. I remember being hit for unexpected page charges by the premier rheumatology journal twenty years ago. There are no good guys in this business. The academic community only has itself...

My conclusion is that the difference between us and animals is that we have a much more sophisticated misunderstanding of our own nature.

I think they are used by two quite different communities, neither of which is aware of the existence of the other term. They are intended to have quite different meanings. Sickness behaviour is typically what occurs in sepsis an flu - no hint of faking it.

I agree, it is an unhelpful concept. It carriesteleological or 'functional' baggage and is really only relevant to mice and dogs, where behaviour is what the vet has to go on. The 'adaptive' argument is trendy but groundless. Many illnesses, including infections have symptoms that might arise...

Sorry Ggl, there was a 'not' missing from that sentence. I am using an iPad and it plays tricks. Something is responsible for people getting better equally often with placebo, so it was not the rituximab.

Local brain infection with virus would normally show up clearly on an MRI scan. Based on what we know of documented brain infection I think it is vanishingly unlikely in ME. I think much the most likely reason that people improve while taking antiviral is that it is nothing to do with the...

We are talking about viruses. And the whole point is that yes high levels may just indicate past infection- so they provide no discrimination and are useless. The fact that it is theoretically possible that tests might have meant something else is irrelevant if in reality they have turned out to...

V Viral antibody levels rise after an acute infection and then may stay high life long. High levels just indicate a past infection. Some tests like IgM titres may point towards recent infection but not ver reliably. It seems that these tests have been over interpreted by 'ME physicians' in the...

The problem with cyclophosphamide is that you cannot blind it because of the side effects. So the cyclo studies alone are not solid evidence.

A true placebo response is only one of several reasons why people get better following treatments. I think it most likely that the original responses do not tell us anything useful about ME. They may have had immune dysfunction associated with lymphoma. The time course of immune dysfunction does...

Yes, areas of research. And that is chiefly hoe F&M saw rituximab, rather than as an instant treatment. Things take time I am afraid.

Responses in lupus are actually high (remember I introduced rituximab for lupus). The problem with rituximab in lupus is that the initial company sponsored trials excluded anyone with significant disease. The design shot itself in the foot. Rituximab is widely used lupus. Failure to respond to...

I think this was about something called Vh4 heavy chain usage, which came up as opposite. I have not heard more from Jo on this. It may not have proved consistent.

There are lots of things in the air. I would keep an eye on Baraniuk's brain studies, T cell conality and mitochondria.

You need to go to Norway and you cannot buy them. The 'placebos' are Oystein Fluge and Olaf Mella. This is the great irony of dedicated scientific physicians. Their humility and honesty is likely to be a hugely powerful placebo. That is why you need properly controlled trials, however good a...

By and large viral testing is only any use if paired samples taken two or more weeks apart immediately following an acute illness show a significant rise. So basically all viral testing for a chronic illness like ME is a waste of time.

Only that it makes no sense to link the experiments to preventing RA. People have been flying this kite since 1985 and nothing has come of it.