Trial Report Plasma cell targeting with the anti-CD38 antibody daratumumab in ME/CFS -a clinical pilot study, 2025, Fluge et al

[ryanc97]

Here’s how I predict things will go, they will find an effect correlated with NK cell and have about half of the non placebo responding similar to the first study.

It will reinforce all the conclusions we know about the first study and remove the placebo effect argument.

The question will still by why the NK cell correlation is so important and how do we make everyone respond. They will then focus research into that.

 

[V.R.T.]

Here’s how I predict things will go, they will find an effect correlated with NK cell and have about half of the non placebo responding similar to the first study.

It will reinforce all the conclusions we know about the first study and remove the placebo effect argument.

The question will still by why the NK cell correlation is so important and how do we make everyone respond. They will then focus research into that.

Surely in that scenario more than half of patients who got the drug would respond because they are only enrolling people with higher NK cell counts.

But other than that, what you've described would be pretty much the best case scenario- especially if NK cell count turned out to just correspond to drug action and raising it/waiting for it to fluctuate over the threshold was all that was required for someone to respond.

I don't know how likely it is but that's what I'm most hoping for.

 

[ryanc97]

Surely in that scenario more than half of patients who got the drug would respond because they are only enrolling people with higher NK cell counts.

But other than that, what you've described would be pretty much the best case scenario- especially if NK cell count turned out to just correspond to drug action and raising it/waiting for it to fluctuate over the threshold was all that was required for someone to respond.

I don't know how likely it is but that's what I'm most hoping for.

I suspect unfortunately because of repeated Covid infections a lot of peoples NK cells and functions are going to be suppressed.

I also don’t think it’s easy to raise NK cells at all. It requires either a very hard to access drug (harder to get than Dara) or self experimentation with things like peptides over a long period with repeat testing.

 

[V.R.T.]

I also don’t think it’s easy to raise NK cells at all. It requires either a very hard to access drug (harder to get than Dara)

But isn't the anktiva guy sort of shopping it around trying to find a clinical use for it? In the scenario we're talking about this would be a good and profitable one.

I suspect unfortunately because of repeated Covid infections a lot of peoples NK cells and functions are going to be suppressed.

That would be really unfortunate- I don't know enough to say how likely it is though.

I think JE said a while back he thought there would be a way around the NK cell problem if the NK correlation proves to be tied to drug action.

 

[jnmaciuch]

And somehow this phenomenon only popped up in the Dara study? The ritux and cyclo studies did not show any form of synchronized response

We don’t know if there were subtle changes in protocol to explain this—for example, ppts being advised about the potential consequences of overexertion just from participating in a trial while severe, informed by ppt experiences in previous trials. Something like that wouldn’t invalidate this trial’s results if everyone got the same spiel, but it would make a comparison to previous trials problematic.

I’d be overjoyed if the drug actually works. Just sharing a difference of opinion about how much we can or can’t conclude from those two observations

 

[Jaybee00]

The NK corr

Except the Twitter guy who responded strongly to Dara had very low NK cell #.

So who knows.

 

[V.R.T.]

Except the Twitter guy who responded strongly to Dara had very low NK cell #.

So who knows.

Is this the guy who responded after six months? I don't know if we can attribute that to the drug.

But if we could it would be interesting.