Question - why has no one, to our knowledge, coincidentally taken a drug which cured their ME/CFS?
OK rituximab was thought to work i.e. after it appeared to cure people who had ME/CFS but that doesn't appear to have held up.
Rituximab looked like a classic case of a phase 2 showing positive outcomes that didn’t hold up in phase 3.
You make a very good point — many drugs have been tested for ME/CFS outside of clinical trials (sometimes prescribed quite liberally, for example by well known ME/CFS specialist physicians) yet none has coincidentally put someone in remission (save for misdiagnosed people) or made more than a handful of people significantly better. Even in the latter case, that the
blinded rituximab trial found a placebo response of 35% tells us to take any reported improvement from an open label, N=1 experiment with a grain of salt. Or rather a mouthful.
Being severe and having had my ME made more severe by a drug, I cannot afford to further deteriorate through an avoidable mistake. My personal policy before attempting any treatment that I may come across is to run the following assessment:
1) side effects: cross-checking multiple sources (for drugs: leaflets from my country, UK & US; NHS website; MedlinePlus.gov; Wikipedia; searching for literature; patient feedback)
2) review the preliminary evidence for ME/CFS, POTS and more or less related conditions; if unavailable, try to judge whether the proposed mechanism of action may be somewhat plausible
3) price, if not reimbursed by social security
4) accessibility, as I am bedbound and do not want the treatment to impose any further burden to my carers
This filters out 99.9% of candidates: many at step 1 and the rest at step 2.