B-/Plasmazell-Depletion bei ME/CFS

Dr. Judith Bellmann-Strobl presented the therapeutic approach of B-cell/plasma cell depletion in patients with ME/CFS, noting at the very outset of her presentation the heterogeneity of the disease. ME/CFS frequently presents with a post-infectious onset and predominantly affects women. In 20–30% of affected individuals, autoantibodies directed against a G protein-coupled receptor (GPCR) can be detected; furthermore, altered B-cell profiles and aberrant cytokine patterns have been observed. Dr. Bellmann-Strobl reported on a case series involving inebilizumab—a CD19-directed monoclonal antibody that functions as a B-cell depletion therapy. Only a very specific subgroup of patients—specifically those with a positive test result for GPCR autoantibodies and a positive response to immunoadsorption—were eligible for inclusion. These patients demonstrated clinical improvement. She further reported on two placebo-controlled pilot studies currently in preparation: one utilizing inebilizumab, with inclusion criteria requiring an infectious trigger for ME/CFS, a positive response to immunoadsorption, and the confirmed presence of autoantibodies. The second pilot study is planned using the active agent isatuximab (an anti-CD38 monoclonal antibody) and requires, among other prerequisites, normal IgG levels and a normal natural killer (NK) cell count. Dr. Bellmann-Strobl concluded by addressing a question regarding viral persistence or latency during B-cell depletion therapy, emphasising that patients participating in these clinical trials would be closely monitored—including through scheduled safety visits, laboratory parameter assessments, and concurrent biomarker analyses.