DOCSLIB.ORG

An Updated Systematic Evidence Review

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
An Updated Systematic Evidence Review Management of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): An Updated Systematic Evidence Review A DRAFT Systematic Evidence Review prepared for: Centers for Disease Control and Prevention December 7, 2020 Investigators: Roger Chou, MD, FACP Marian McDonagh, Pharm.D. Jessica C. Griffin, MS Sara Grusing, BA Pacific Northwest Evidence-based Practice Center Roger Chou, MD, Director Marian McDonagh, PharmD, Co-Director Copyright © 2020 by Oregon Health & Science University Portland, Oregon 97239. All rights reserved. Structured Abstract Objectives. Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) can have profound effects on function and quality of life. This report updates a 2014 Agency for Healthcare Research Quality (AHRQ)-funded review in order to synthesize the evidence on evaluation and management of ME/CFS. It also expands upon the prior AHRQ review by including children as well as adults, evaluating harms as well as benefits of diagnosis, and evaluating effects of treatment on depression, anxiety, sleep quality, pain, and other symptoms associated with ME/CFS in addition to fatigue, function, and quality of life. Data Sources. MEDLINE (1988 to January 2019), PsycINFO (1988 to January 2019), Embase (through January 2019) and the Cochrane Library (through January 2019); supplemented by review of reference lists and the 2014 AHRQ review. Review Methods. Articles were selected for review if they included: 1) evaluation of patients with fatigue, 2) diagnosis of ME/CFS, or 3) treatments (pharmacological, nonpharmacological, dietary, or complementary and alternative therapies) of ME/CFS. We abstracted data on the frequency of non-ME/CFS conditions in patients presenting with fatigue; benefits and harms of diagnosis of ME/CFS versus non-diagnosis; and benefits and harms of treatments. Two investigators reviewed abstracts and full-text articles for inclusion based on predefined criteria. Risk of bias was assessed using predefined criteria. Discrepancies were resolved through discussion and consensus, with a third investigator if needed. Random effects meta-analyses were conducted on trials of exercise and cognitive therapy; where evidence was unsuitable for combining, it was synthesized qualitatively. The strength of evidence was assessed using methods recommended by the AHRQ Methods Guide for Effectiveness and Comparative Effectiveness Reviews. Results. We identified 4,951 potentially relevant articles, selected 636 for full-text review, and included 72 studies in 91 publications (1 systematic review and 5 observational studies on diagnosis and 66 trials of treatments). A systematic review of patients with fatigue or tiredness in primary care settings found that the most common non-ME/CFS conditions were depression (18.5%), serious somatic diseases (4.3%), anemia (2.8%), and malignancy (0.6%). In specialty settings of patients referred for evaluation of possible ME/CFS, the most common non-ME/CFS conditions were psychological (15% to 51%) and sleep disorders (6% to 30%). No study evaluated benefits or harms of ME/CFS diagnosis versus non-diagnosis. Sixty-six trials evaluated treatments for ME/CFS. Thirty-three trials were included in the prior AHRQ report and 33 trials were new since the prior report. CBT and exercise therapy were associated with improved fatigue, function, and other outcomes versus inactive control therapies, but the magnitude of effects based on average benefits was small to moderate. These trials demonstrated unexplained statistical heterogeneity in pooled estimates and contained methodological limitations. Additionally, the applicability of findings to patients with severe ME/CFS diagnosed using more current, specific case definitions was uncertain. Other pharmacological, nonpharmacological, dietary, and complementary and alternative therapies were ineffective, or evidence of effectiveness was too limited to guide clinical practice. Reporting of harms across trials was suboptimal, with limited evidence that exercise and CBT were not associated with increased risk of serious adverse events or worsening of symptoms. In Management of ME/CFS DRAFT Systematic Review Pacific Northwest Evidence-based Practice Center ii adolescents with ME/CFS, limited evidence found CBT (family based or involving parents) associated with improved function and school attendance versus inactive therapies, but differences were not statistically significant. Limitations. Treatment trials had methodological limitations. Most interventions and comparisons were evaluated in few trials, most trials used older ME/CFS case definitions, and there was limited information on how key characteristics and subgroups of patients impacted outcomes. There was unexplained statistical heterogeneity in meta-analyses, study inclusion was restricted to English language publications and formal methods for determining small sample effects were not performed due to small numbers of studies. Conclusions. Evidence on effective treatments for ME/CFS remains limited. Although graded exercise and CBT were more effective than inactive control therapies (usual care, usual specialist care, or an attention control) in improving fatigue, function, and other outcomes, the magnitude of effects was small to moderate and methodological and other limitations (imprecision, inconsistency, uncertain generalizability) precluded strong conclusions. Other therapies were not shown to be effective or require additional evidence to verify effectiveness. Non-ME/CFS conditions were common in patients presenting with fatigue. Management of ME/CFS DRAFT Systematic Review Pacific Northwest Evidence-based Practice Center iii Contents Introduction ..................................................................................................................................... 1 Background ..................................................................................................................................... 1 Purpose ............................................................................................................................................ 5 Methods........................................................................................................................................... 5 Topic Development and Refinement .......................................................................................... 5 Data Sources and Searches ......................................................................................................... 6 Process for Study Selection ........................................................................................................ 6 Inclusion criteria ..................................................................................................................... 6 Data Extraction and Data Management ...................................................................................... 7 Risk of Bias of Individual Studies Assessment .......................................................................... 7 Assessing Research Applicability ............................................................................................... 8 Data Synthesis ............................................................................................................................. 8 Grading the Body of Evidence for Each Key Question ............................................................ 10 Peer Review and Public Commentary ...................................................................................... 10 Results ........................................................................................................................................... 11 Results of Literature Searches .................................................................................................. 11 Key Question 1. In patients undergoing evaluation for possible ME/CFS, what is the frequency of non-ME/CFS conditions? .................................................................................... 12 Key Points ................................................................................................................................. 12 Detailed Synthesis ..................................................................................................................... 12 Key Question 2. What are the benefits and harms of diagnosing ME/CFS vs. non-diagnosis? 16 Key Points ................................................................................................................................. 16 Detailed Synthesis ..................................................................................................................... 16 Key Question 3. What are the benefits and harms of therapeutic interventions for patients with ME/CFS and how do they vary by patient subgroups?............................................................. 17 Key Question 3a. Interventions for treating ME/CFS Key Question 3b. Interventions for treating symptoms commonly present in persons with ME/CFS (poor sleep, orthostatic intolerance, pain, fatigue, cognitive problems, depression, multiple chemical sensitivity, gastrointestinal symptoms, urinary symptoms, etc.) ................................................................. 17 Key Points ................................................................................................................................. 17 Exercise Therapy .................................................................................................................
Load more

Recommended publications
  • Volume No. -3 Perspectives on Global Development and Technology
    Contents Technology and Development on Global Perspectives Volume Special issue: The Greater Middle East in Global Politics—Social Science Perspectives Perspectives on on the Changing Geography of the World Politics (edited by Mehdi Parvizi Amineh) Acknowledgements 3 List of Contributors Global Development 9 List of Abbreviations Articles 13 mehdi parvizi amineh, Introduction: Theoretical and Methodological Approaches to and Technology the Study of the Greater Middle East Part One: Foreign Intervention and Social Transformation in the Greater Middle East 57 mehdi parvizi amineh & henk houweling, IR-Theory and Transformations in the Greater Middle East: The Role of the United States 87 simon bromley, Connecting Central Eurasia to the Middle East in American Foreign Policy Towards Afghanistan and Pakistan: 1979-Present 109 robert m. cutler, US-Russian Strategic Relations and the Structuration of Central Asia Part Two: State, Society, and Economy in the Greater Middle East 129 mehdi parvizi amineh & s. n. eisenstadt, The Iranian Revolution: The Multiple Volume no. -3 Contexts of the Iranian Revolution 159 eva patricia rakel, The Iranian Foreign Policy since the Iranian Islamic Revolution: 1979-2006 189 mehran kamrava, The Middle East’s Democracy Deficit in Comparative Perspective 215 mehdi parvizi amineh, The Challenges of Modernity: The Case of Political Islam 229 nilgun onder, The Turkish Political Economy: Globalization and Regionalism 261 louisa dris-aït-hamadouche & yahia zoubir, The Maghreb: Social, Political, and Economic Developments 291 mirzohid rahimov, From Soviet Republics to Independent Countries: Challenges of Transition in Central Asia 313 richard pomfret, Central Asia since the Dissolution of the Soviet Union: Economic Reforms and Their Impact on State-Society Relations 345 fred h.
    [Show full text]
  • The 46Th Annual
    the 46th Annual 2018 TO BENEFIT NANTUCKET COMMUNITY SAILING PROUD TO SPONSOR MURRAY’S TOGGERY SHOP 62 MAIN STREET | 800-368-3134 2 STRAIGHT WHARF | 508-325-9600 1-800-892-4982 2018 elcome to the 15th Nantucket Race Week and the 46th Opera House Cup Regatta brought to you by Nantucket WCommunity Sailing, the Nantucket Yacht Club and the Great Harbor Yacht Club. We are happy to have you with us for an unparalleled week of competitive sailing for all ages and abilities, complemented by a full schedule of awards ceremonies and social events. We look forward to sharing the beauty of Nantucket and her waters with you. Thank you for coming! This program celebrates the winners and participants from last year’s Nantucket Race Week and the Opera House Cup Regatta and gives you everything you need to know about this year’s racing and social events. We are excited to welcome all sailors in the Nantucket community to join us for our inaugural Harbor Rendezvous on Sunday, August 12th. We are also pleased to welcome all our competitors, including young Opti and 420 racers; lasers, Hobies and kite boarders; the local one design fleets; the IOD Celebrity Invitational guest tacticians and amateur teams; and the big boat regatta competitors ranging from Alerions and Wianno Seniors to schooners and majestic classic yachts. Don’t forget that you can go aboard and admire some of these beautiful classics up close, when they will be on display to the public for the 5th Classic Yacht Exhibition on Saturday, August 18th.
    [Show full text]
  • Brian M. Mcdonald, Ph.D., S.E., F.ASCE
    Brian M. McDonald, Ph.D., S.E., F.ASCE Corporate Vice President & Principal Engineer | Buildings & Structures 149 Commonwealth Drive | Menlo Park, CA 94025 (650) 688-6946 tel | [email protected] Professional Profile Dr. McDonald specializes in the design and construction of complex structures, extreme loading, and the causes and repair of damage to the built environment. During more than 30 years at Exponent, he has evaluated problems with the design and construction of wood frame, reinforced concrete, post-tensioned concrete and steel buildings, as well as bridges, tunnels, industrial structures, power transmission lines, communication towers, cable-supported and fabric structures. Dr. McDonald has investigated structures damaged by wind, snow, explosion, fire, construction errors, design defects, decay and corrosion, as well as hundreds of structures damaged by seismic shaking after the Loma Prieta, Northridge, San Simeon, Hawaii earthquakes and others. Dr. McDonald has designed steel and concrete structures, transmission line structures and substation components, and repairs to damaged buildings, Dr. McDonald's work often includes nonlinear and dynamic structural analysis, instrumentation and full-scale testing of structures, and material failures including fracture and plasticity analyses. In addition to damage investigations, Dr. McDonald also provides peer review services for structural design of complex structures, including safety-critical nuclear power plant structures. Dr. McDonald has special expertise in the field of quantitative risk assessment, which he has applied to nuclear power plants, critical national laboratory infrastructure, petrochemical facilities, and electric power transmission facilities. Dr. McDonald has held several positions in the fields of structural engineering and software design, most recently as Chief Analyst at Krawinkler, Luth, and Associates, a leading structural design firm.
    [Show full text]
  • Curriculum Vitae
    Prepared: April 29, 2021 University of California, San Francisco CURRICULUM VITAE Name: Britt-Marie E Ljung, MD Position: Recalled HCOP Pathology School of Medicine Address: Box 4034 1825 4th Street, Room L2181C University of California, San Francisco San Francisco, CA 94143 Voice: 353-7048 Fax: 353-7676 Email: [email protected] EDUCATION 1969 - 1971 Karolinska Institute Pre- B.S. Medicine Med School , Stockholm, Sweden 1971 - 1975 Karolinska Institute M.D. Medicine Medical School, Stockholm, Sweden 1975 - 1977 Rotating Internship, Intern Medicine & Psychiatry, and General Internal Medicine and Practice, Koping Hospital, Koping, Surgery, Karolinska Hospital, Stockholm, Sweden 1977 - 1978 Oncology, Karolinska Resident Medicine, Sweden Hospital (7 months), Stockholm, 1978 - 1980 Karolinska Hospital, Resident Cytology Stockholm, Sweden 1980 - 1983 UCLA School of Resident Pathology Medicine, Los Angeles, California LICENSES, CERTIFICATION 1980 ECFMG exam 1980 FLEX 1981 California license to practice medicine 1985 Diplomat, American Board of Pathology, Anatomic Pathology 1 of 62 Prepared: April 29, 2021 1989 American Board of Pathology (Cytopathology) 2009 Certificate of Special Expertise (CSE) in Ultrasound Guided FNA of Thyroid and Breast, issued by College of American Pathologists 2014 Five year Certification in Ultrasound-Guided Fine Needle Aspiration issued by College of American Pathologists (CAP). 2015 UCSF Blingual Clinician Certification for Swedish PRINCIPAL POSITIONS HELD 1981 - 1982 Visiting Assistant Professor of Pathology,
    [Show full text]
  • Journal of Indo-Pacific Affairs
    The AIR FORCE Journal of Indo-Pacific Affairs SPRING 2019 Volume 2, No. 1 Senior Leader Perspective Introduction to Indo-Pacific Security Challenges ❘ 3 ADM Phil Davidson, US Navy Features A Pathway toward Enhancing the US Air Force–Indian Air Force Partnership and Deterrence in the Indo-Pacific Region ❘ 11 Stephen F. Burgess Preparing for the Last War Insurgency in the Era of Great Power Competition ❘ 47 Karl Umbrasas The 2016 European Global Strategy, European Union Defense Integration, and Asian–European Security Cooperation in a Declining Multilateral International Order ❘ 67 David J. Garcia Cantalapiedra Critical Review Essay Anatomy of Failure Why America Loses Every War It Starts ❘ 80 Manabrata Guha Book Review Asia-Pacific Security: An Introduction by Joanne Wallis and Andrew Carr, eds. ❘ 103 Jieruo Li, PhD candidate, Reviewer Editorial Advisors Lt Col Darin Gregg, Director, Air University Press Gen Herbert J. “Hawk” Carlisle, USAF, Retired; President and CEO, National Defense Industrial Association Amb. Daniel Shields, Department of State, Retired Dr. Matthew C. Stafford, Chief Academic Officer, Air Education and Training Command Col Jeff Donnithorne, USAF, PhD, Chief Academic Officer, Air University Reviewers Gp Capt Nasim Abbas Dr. Jessica Jordan Instructor, Air War College Assistant Professor, Air Force Culture and Language Center Pakistan Air Force Air University Dr. Sascha-Dominik “Dov” Bachmann Mr. Chris Kolakowski Assoc. Prof. & Director, Centre of Conflict, Rule of Law and Director Society The General Douglas MacArthur Memorial Bournemouth University (United Kingdom) Dr. Carlo Kopp Dr. Lewis Bernstein Lecturer Historian, retired Monash University (Australia) United States Army Dr. Amit Kumar Dr. Paul J. Bolt President Professor, Political Science AAA International Security Consultants US Air Force Academy Lt Col Scott D.
    [Show full text]
  • Kate Fitzgerald
    In This Issue: 2020 Young Investigator Awardees pg. 3-9 In Memorium page pg. 14-15 New Member Mini-Bios pg. 19-21 Trials of Interferon Lambda pg. 31 Cytokines 2021 Hybrid Meetin pg. 24-27 Signals THE INTERNATIONAL CYTOKINE & INTERFERON SOCIETY + NEWSLETTER APRIL 2021 I VOLUME 9 I NO. 1 A NOTE FROM THE ICIS PRESIDENT Kate Fitzgerald Dear Colleagues, Greetings from the International Cytokine and Interferon Society! I hope you and your family are staying safe during these still challenging times. Thankfully 2020 is behind us now. We have lived through the COVID-19 pandemic, an event that will continue to impact our lives for some time and likely alter how we live in the future. Despite the obvious difficulties of this past year, I can’t help but marvel at the scientific advances that have been made. With everything from COVID-19 testing, to treatments and especially to the rapid pace of vaccine development, we are so better off today than even a few months back. The approval of remarkably effective COVID-19 vaccines now rolling out in the US, Israel, UK, Europe and across the globe, brings light at the end of the tunnel. The work of many of you has helped shape our understanding of the host response to Sars-CoV2 and the ability of this virus to limit antiviral immunity while simultaneously driving a cytokine driven hyperinflammatory response leading to deadly consequences for patients. The knowledge gained from all of your efforts has been put to good use to stem the threat of this deadly virus.
    [Show full text]
  • Inquiry Into NHS Service Provision for ME/CFS
    All-Party Parliamentary Group on ME Inquiry into NHS Service Provision for ME/CFS March 2010 All-Party Parliamentary Group on ME Inquiry into NHS Service Provision for ME/CFS Contents Foreword 3 Introduction 4 Limitations of the Inquiry 4 Review of Current Treatments 4 Review of Adult Services 9 Review of Children’s Services 12 Training 14 Research 16 Disability and Benefits 16 Conclusion 17 Recommendations 18 Appendix 1: APPG Inquiry on NHS service provision for people with ME: Terms of reference 21 References 24 2 All-Party Parliamentary Group on ME Inquiry into NHS Service Provision for ME/CFS Foreword The All Party Parliamentary Group on M.E. (Myalgic Encephalomyelitis) strives to support the improvement of health and social care of all people with M.E. in the UK. The APPG accepts the WHO Classification of M.E. (ICD G93.3) as a neurological condition and welcomed the recognition by the Department of Health that M.E. is a long term neurological condition. Department of Health funding in 2004/05 and 2005/06 resulted in the establishment of 13 Clinical Network Coordinating Centres and some 50 Local Multidisciplinary Teams. However subsequent changes in NHS organisation and budget setting arrangements have since made it far more difficult to establish the level of investment into the care of these patients. It has also become apparent that some of these newly established secondary services are having to cope with significant reductions in funding. As a result, some have either closed or are under threat of closure. Patient group surveys and letters to MPs and members of the House of Lords continue to identify high levels of patient concern about the services which are being provided and further concerns about the way in which the recommendations contained in the 2007 guideline on ME/CFS from NICE could result in an inflexible approach to management.
    [Show full text]
  • The Rise and Fall of the Wessely School
    THE RISE AND FALL OF THE WESSELY SCHOOL David F Marks* Independent Researcher Arles, Bouches-du-Rhône, Provence-Alpes-Côte d'Azur, 13200, France *Address for correspondence: [email protected] Rise and Fall of the Wessely School THE RISE AND FALL OF THE WESSELY SCHOOL 2 Rise and Fall of the Wessely School ABSTRACT The Wessely School’s (WS) approach to medically unexplained symptoms, myalgic encephalomyelitis and chronic fatigue syndrome (MUS/MECFS) is critically reviewed using scientific criteria. Based on the ‘Biopsychosocial Model’, the WS proposes that patients’ dysfunctional beliefs, deconditioning and attentional biases cause illness, disrupt therapies, and lead to preventable deaths. The evidence reviewed here suggests that none of the WS hypotheses is empirically supported. The lack of robust supportive evidence, fallacious causal assumptions, inappropriate and harmful therapies, broken scientific principles, repeated methodological flaws and unwillingness to share data all give the appearance of cargo cult science. The WS approach needs to be replaced by an evidence-based, biologically-grounded, scientific approach to MUS/MECFS. 3 Rise and Fall of the Wessely School Sickness doesn’t terrify me and death doesn’t terrify me. What terrifies me is that you can disappear because someone is telling the wrong story about you. I feel like that’s what happened to all of us who are living this. And I remember thinking that nobody’s coming to look for me because no one even knows that I went missing. Jennifer Brea, Unrest, 20171. 1. INTRODUCTION This review concerns a story filled with drama, pathos and tragedy. It is relevant to millions of seriously ill people with conditions that have no known cause or cure.
    [Show full text]
  • Fall-2019.Pdf
    VOL. 2 NO. 3 FALL 2019 Disclaimer: The views and opinions expressed or implied in the Journal of Indo-Pacific Affairs ( JIPA) are those of the authors and should not be construed as carrying the official sanction of the Department of Defense, Air Force, Air Education and Training Command, Air University, or other agencies or departments of the US government. The ar- ticles may be reproduced in whole or in part without permission. If it is reproduced, the JIPA requests a courtesy line. SENIOR LEADER PERSPECTIVE 3 LindaAustralia Reynolds in an Age of Strategic Competition FEATURES 8 Russia, South Asia, and the United States A New Great Game? Stephen F. Burgess 33 Airmen and Unmanned Aerial Vehicles The Danger of Generalization Natalia Jevglevskaja Jai Galliott 66 Japan and the Nuclear Challenge in a New Era of Rising Tensions Balancing Between Disarmament and Deterrence Sayuri Romei 85 Cooperative Rivalry Understanding Indo-Pakistani Ties Using Treaty Networks Michael O. Slobodchikoff Aakriti A. Tandon BOOK REVIEW 104 Nomonhan 1939: The Red Army’s Victory that Shaped World War II Stuart D. Goldman Reviewer: H. Allen Skinner Editorial Advisors Lt Col Darin Gregg, Director, Air University Press Gen Herbert J. “Hawk” Carlisle, USAF, Retired; President and CEO, National Defense Industrial Association Amb. Daniel Shields, Department of State, Retired Dr. Matthew C. Stafford, Chief Academic Officer, Air Education and Training Command Col Jeff Donnithorne, USAF, PhD, Chief Academic Officer, Air University Reviewers Gp Capt Nasim Abbas Mr. Chris Kolakowski Instructor, Air War College Director Pakistan Air Force The General Douglas MacArthur Memorial Dr. Sascha-Dominik “Dov” Bachmann Dr.
    [Show full text]
  • Première Année
    BRON LES ALIZÉS DÉCINES CINÉ TOBOGGAN SAINT-PRIEST LE SCÉNARIO VÉNISSIEUX GÉRARD PHILIPE Est-Ecrans LE PROGRAMME DES CINÉMAS DE L’EST LYONNAIS DU 12 SEPTEMBRE AU 9 OCTOBRE 2018 VINCENT WILLIAM LACOSTE LEBGHIL PREMIÈRE ANNÉE UN FILM DE THOMAS LILTI www.grac.asso.fr MENSUEL GRATUIT N° 228 B BRON LES ALIZÉS D DÉCINES CINÉ TOBOGGAN S SAINT-PRIEST LE SCÉNARIO V VÉNISSIEUX GÉRARD PHILIPE À L’AFFICHE S V D S V S B D S B V D B D S V Alad’2 Break Les Frères Sisters King : de Montgomery à Memphis Un nouveau jour sur terre Le poulain Sugarland Vaurien Après avoir libéré Bagdad de l’emprise de A la suite d’un grave accident, Lucie craint de voir Charlie et Elie Sisters évoluent dans un Depuis le boycott des bus de Montgomery en Passionné de littérature, Sinan a toujours voulu Arnaud Jaurès, 25 ans, novice en politique, intègre Le sucre est partout ! Damon Gameau va tester Quand Redouane pousse la porte de son son terrible Vizir, Aladin s’ennuie au palais se briser le rêve de sa vie : devenir danseuse. Elle monde sauvage et hostile et n'éprouvent 1955, l’une des premières actions inspirées par être écrivain. De retour dans son village natal par un concours de circonstances l’équipe de les effets d’une alimentation haute en sucre agence Pôle Emploi, il se voit une nouvelle quitte les beaux quartiers et part en banlieue à la aucun état d'âme à tuer. C'est leur métier. Un Martin Luther King, jusqu’à son assassinat, d’Anatolie, il met toute son énergie à trouver sur un corps en bonne santé.
    [Show full text]
  • ME Is Not a Functional Disorder
    ME Association Recipient: Sir Andrew Dillon Letter: Greetings, M.E. is not a functional disorder Comments Name Location Date Comment Carol Bryant Mottram, 2017-09-27 My daughter has ME and clearly this illness is NOT in her England, UK mind it is a physical illness Clare Crofts Rochdale, 2017-09-27 My daughter had Very Severe ME for the last 6years, was England, UK diagnosed as terminal 18 months ago and died in May this year. This disease is horrendous and needs the medical community to take it seriously Sheena young Prestatyn, 2017-09-27 M.E is not a functional disorder and should not be treated as Wales, UK such. Julie Holliday Shrewsbury, 2017-09-27 I have ME and have been treated appallingly by the NHS. England, UK Paul Winter Hailsham, 2017-09-27 I have ME. Some hospitals, such as the National England, UK Neurological Hospital in Queen Square, London, are already routinely ignoring the NICE guidelines and diagnosing people with ME as having FND. This is unacceptable given the mounting evidence that ME is a neuro-imune disease. Jane Iles Cheddar, 2017-09-27 This is too important. NICE need to look at the facts and England, UK listen to ME specialists and more importantly, the sufferers Kathie Cortese UK 2017-09-27 I have got M.E and I know it's not a " functional disorder" NICE need to use more recent up-to-date world studies, and consult with ME patients, and experts on ME Jayne Glover Warminster, 2017-09-27 I don't want other people to suffer the indignity and England, UK humiliation that I have endured for the last 15 years.
    [Show full text]
  • Hemispherx Biopharma, Inc
    Hemispherx Biopharma, Inc. HEB‐NYSE EXECUTIVE INFORMATIONAL OVERVIEW® November 27, 2016 Company Description Hemispherx Biopharma, Inc. (or “the Company”) is a specialty pharmaceutical company addressing critical unmet medical needs. The Company has invested over two decades of R&D into safe, effective ways to modulate and amplify the immune system, and is now poised to enter a confirmatory Phase III U.S. trial with an RNA† Hemispherx Biopharma, Inc. macromolecule that could become the only FDA‐approved therapy 1617 JFK Blvd., Suite 500 for chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME). Philadelphia, PA 19103 This candidate, Ampligen®, was approved for CFS/ME in Argentina in Phone: (215) 988‐0080 August 2016 and is available to patients in Europe through an early access program (EAP). CFS/ME is a debilitating disease with no Fax: (215) 988‐1739 www.hemispherx.net/ known treatment to date but very active patient advocacy groups. Hemispherx also holds rights to an FDA‐approved product for genital warts, Alferon N Injection®, which is believed to be the world’s only Ticker (Exchange) HEB (NYSE) approved natural interferon (IFN). Hemispherx has refined Alferon’s Recent Price (11/25/2016)* $0.85 manufacturing to drastically increase efficiencies and reduce costs, and now seeks FDA approval for the new production method before 52‐week Range $0.72 ‐ $2.64 relaunching Alferon. Hemispherx is headquartered in Philadelphia Shares Outstanding** ~24.1 million with GMP manufacturing and research facilities in New Jersey. Market Capitalization ~$20.5 million Average 3‐month Volume 110,574 Key Points Insider Ownership ~3.6 million The Ampligen® technology has also shown utility as a broad‐ Institutional Ownership ~5% spectrum antiviral that could help seasonal flu vaccines work EPS (Qtr.
    [Show full text]