Benefit from B-Lymphocyte Depletion Using the Anti-CD20 Antibody Rituximab in Chronic Fatigue Syndrome. A Double-Blind and Placebo-Controlled Study
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{"title"=>"Benefit from b-lymphocyte depletion using the anti-CD20 antibody rituximab in chronic fatigue syndrome. a double-blind and placebo-controlled study", "type"=>"journal", "authors"=>[{"first_name"=>"Øystein", "last_name"=>"Fluge", "scopus_author_id"=>"6602991079"}, {"first_name"=>"Ove", "last_name"=>"Bruland", "scopus_author_id"=>"7005318708"}, {"first_name"=>"Kristin", "last_name"=>"Risa", "scopus_author_id"=>"54391752900"}, {"first_name"=>"Anette", "last_name"=>"Storstein", "scopus_author_id"=>"6602619288"}, {"first_name"=>"Einar K.", "last_name"=>"Kristoffersen", "scopus_author_id"=>"7003970751"}, {"first_name"=>"Dipak", "last_name"=>"Sapkota", "scopus_author_id"=>"25225935800"}, {"first_name"=>"Halvor", "last_name"=>"Næss", "scopus_author_id"=>"9337633300"}, {"first_name"=>"Olav", "last_name"=>"Dahl", "scopus_author_id"=>"7101971144"}, {"first_name"=>"Harald", "last_name"=>"Nyland", "scopus_author_id"=>"7006236733"}, {"first_name"=>"Olav", "last_name"=>"Mella", "scopus_author_id"=>"7004099256"}], "year"=>2011, "source"=>"PLoS ONE", "identifiers"=>{"sgr"=>"80054793227", "pui"=>"362778078", "doi"=>"10.1371/journal.pone.0026358", "pmid"=>"22039471", "isbn"=>"1932-6203 (Electronic)\\r1932-6203 (Linking)", "scopus"=>"2-s2.0-80054793227", "issn"=>"19326203"}, "id"=>"1ad662e0-50fa-3046-9304-15c7433c86ee", "abstract"=>"BACKGROUND: Chronic fatigue syndrome (CFS) is a disease of unknown aetiology. Major CFS symptom relief during cancer chemotherapy in a patient with synchronous CFS and lymphoma spurred a pilot study of B-lymphocyte depletion using the anti-CD20 antibody Rituximab, which demonstrated significant clinical response in three CFS patients.\\n\\nMETHODS AND FINDINGS: In this double-blind, placebo-controlled phase II study (NCT00848692), 30 CFS patients were randomised to either Rituximab 500 mg/m(2) or saline, given twice two weeks apart, with follow-up for 12 months. Xenotropic murine leukemia virus-related virus (XMRV) was not detected in any of the patients. The responses generally affected all CFS symptoms. Major or moderate overall response, defined as lasting improvements in self-reported Fatigue score during follow-up, was seen in 10 out of 15 patients (67%) in the Rituximab group and in two out of 15 patients (13%) in the Placebo group (p = 0.003). Mean response duration within the follow-up period for the 10 responders to Rituximab was 25 weeks (range 8-44). Four Rituximab patients had clinical response durations past the study period. General linear models for repeated measures of Fatigue scores during follow-up showed a significant interaction between time and intervention group (p = 0.018 for self-reported, and p = 0.024 for physician-assessed), with differences between the Rituximab and Placebo groups between 6-10 months after intervention. The primary end-point, defined as effect on self-reported Fatigue score 3 months after intervention, was negative. There were no serious adverse events. Two patients in the Rituximab group with pre-existing psoriasis experienced moderate psoriasis worsening.\\n\\nCONCLUSION: The delayed responses starting from 2-7 months after Rituximab treatment, in spite of rapid B-cell depletion, suggests that CFS is an autoimmune disease and may be consistent with the gradual elimination of autoantibodies preceding clinical responses. The present findings will impact future research efforts in CFS.\\n\\nTRIAL REGISTRATION: ClinicalTrials.gov NCT00848692.", "link"=>"http://www.mendeley.com/research/benefit-blymphocyte-depletion-using-anticd20-antibody-rituximab-chronic-fatigue-syndrome-doubleblind", "reader_count"=>106, "reader_count_by_academic_status"=>{"Professor > Associate Professor"=>3, "Librarian"=>3, "Researcher"=>31, "Student > Doctoral Student"=>4, "Student > Ph. D. Student"=>18, "Student > Postgraduate"=>2, "Other"=>17, "Student > Master"=>12, "Student > Bachelor"=>7, "Lecturer"=>2, "Lecturer > Senior Lecturer"=>2, "Professor"=>5}, "reader_count_by_user_role"=>{"Professor > Associate Professor"=>3, "Librarian"=>3, "Researcher"=>31, "Student > Doctoral Student"=>4, "Student > Ph. D. Student"=>18, "Student > Postgraduate"=>2, "Other"=>17, "Student > Master"=>12, "Student > Bachelor"=>7, "Lecturer"=>2, "Lecturer > Senior Lecturer"=>2, "Professor"=>5}, "reader_count_by_subject_area"=>{"Agricultural and Biological Sciences"=>28, "Arts and Humanities"=>2, "Philosophy"=>1, "Chemistry"=>2, "Economics, Econometrics and Finance"=>1, "Engineering"=>1, "Biochemistry, Genetics and Molecular Biology"=>1, "Materials Science"=>1, "Mathematics"=>2, "Medicine and Dentistry"=>53, "Neuroscience"=>1, "Sports and Recreations"=>1, "Pharmacology, Toxicology and Pharmaceutical Science"=>3, "Physics and Astronomy"=>1, "Psychology"=>3, "Social Sciences"=>4, "Immunology and Microbiology"=>1}, "reader_count_by_subdiscipline"=>{"Materials Science"=>{"Materials Science"=>1}, "Medicine and Dentistry"=>{"Medicine and Dentistry"=>53}, "Social Sciences"=>{"Social Sciences"=>4}, "Sports and Recreations"=>{"Sports and Recreations"=>1}, "Physics and Astronomy"=>{"Physics and Astronomy"=>1}, "Psychology"=>{"Psychology"=>3}, "Mathematics"=>{"Mathematics"=>2}, "Pharmacology, Toxicology and Pharmaceutical Science"=>{"Pharmacology, Toxicology and Pharmaceutical Science"=>3}, "Arts and Humanities"=>{"Arts and Humanities"=>2}, "Engineering"=>{"Engineering"=>1}, "Chemistry"=>{"Chemistry"=>2}, "Neuroscience"=>{"Neuroscience"=>1}, "Economics, Econometrics and Finance"=>{"Economics, Econometrics and Finance"=>1}, "Immunology and Microbiology"=>{"Immunology and Microbiology"=>1}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>28}, "Biochemistry, Genetics and Molecular Biology"=>{"Biochemistry, Genetics and Molecular Biology"=>1}, "Philosophy"=>{"Philosophy"=>1}}, "reader_count_by_country"=>{"Netherlands"=>2, "Norway"=>3, "United States"=>4, "Denmark"=>1, "United Kingdom"=>2, "Israel"=>1, "Australia"=>1, "Germany"=>1}, "group_count"=>8}

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  • {"files"=>["https://ndownloader.figshare.com/files/365443", "https://ndownloader.figshare.com/files/365539", "https://ndownloader.figshare.com/files/365578", "https://ndownloader.figshare.com/files/365634", "https://ndownloader.figshare.com/files/365695", "https://ndownloader.figshare.com/files/365728", "https://ndownloader.figshare.com/files/365792", "https://ndownloader.figshare.com/files/365835", "https://ndownloader.figshare.com/files/366019"], "description"=>"<div><h3>Background</h3><p>Chronic fatigue syndrome (CFS) is a disease of unknown aetiology. Major CFS symptom relief during cancer chemotherapy in a patient with synchronous CFS and lymphoma spurred a pilot study of B-lymphocyte depletion using the anti-CD20 antibody Rituximab, which demonstrated significant clinical response in three CFS patients.</p> <h3>Methods and Findings</h3><p>In this double-blind, placebo-controlled phase II study (NCT00848692), 30 CFS patients were randomised to either Rituximab 500 mg/m<sup>2</sup> or saline, given twice two weeks apart, with follow-up for 12 months. Xenotropic murine leukemia virus-related virus (XMRV) was not detected in any of the patients.</p> <p>The responses generally affected all CFS symptoms. Major or moderate overall response, defined as lasting improvements in self-reported Fatigue score during follow-up, was seen in 10 out of 15 patients (67%) in the Rituximab group and in two out of 15 patients (13%) in the Placebo group (p = 0.003). Mean response duration within the follow-up period for the 10 responders to Rituximab was 25 weeks (range 8–44). Four Rituximab patients had clinical response durations past the study period. General linear models for repeated measures of Fatigue scores during follow-up showed a significant interaction between time and intervention group (p = 0.018 for self-reported, and p = 0.024 for physician-assessed), with differences between the Rituximab and Placebo groups between 6–10 months after intervention. The primary end-point, defined as effect on self-reported Fatigue score 3 months after intervention, was negative. There were no serious adverse events. Two patients in the Rituximab group with pre-existing psoriasis experienced moderate psoriasis worsening.</p> <h3>Conclusion</h3><p>The delayed responses starting from 2–7 months after Rituximab treatment, in spite of rapid B-cell depletion, suggests that CFS is an autoimmune disease and may be consistent with the gradual elimination of autoantibodies preceding clinical responses. The present findings will impact future research efforts in CFS.</p> <h3>Trial registration</h3><p>ClinicalTrials.gov <a href=\"http://clinicaltrials.gov/ct2/show/NCT00848692\">NCT00848692</a></p> </div>", "links"=>[], "tags"=>["b-lymphocyte", "depletion", "anti-cd20", "antibody", "rituximab", "double-blind", "placebo-controlled"], "article_id"=>132243, "categories"=>["Physiology", "Ecology", "Mental Health", "Pharmacology", "Immunology"], "users"=>["Øystein Fluge", "Ove Bruland", "Kristin Risa", "Anette Storstein", "Einar K. Kristoffersen", "Dipak Sapkota", "Halvor Næss", "Olav Dahl", "Harald Nyland", "Olav Mella"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0026358.s001", "https://dx.doi.org/10.1371/journal.pone.0026358.s002", "https://dx.doi.org/10.1371/journal.pone.0026358.s003", "https://dx.doi.org/10.1371/journal.pone.0026358.s004", "https://dx.doi.org/10.1371/journal.pone.0026358.s005", "https://dx.doi.org/10.1371/journal.pone.0026358.s006", "https://dx.doi.org/10.1371/journal.pone.0026358.s007", "https://dx.doi.org/10.1371/journal.pone.0026358.s008", "https://dx.doi.org/10.1371/journal.pone.0026358.s009"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/Benefit_from_B_Lymphocyte_Depletion_Using_the_Anti_CD20_Antibody_Rituximab_in_Chronic_Fatigue_Syndrome_A_Double_Blind_and_Placebo_Controlled_Study/132243", "title"=>"Benefit from B-Lymphocyte Depletion Using the Anti-CD20 Antibody Rituximab in Chronic Fatigue Syndrome. A Double-Blind and Placebo-Controlled Study", "pos_in_sequence"=>0, "defined_type"=>4, "published_date"=>"2011-10-19 00:37:23"}
  • {"files"=>["https://ndownloader.figshare.com/files/722542"], "description"=>"<p>Approximately 60 patients with CFS diagnosed by a neurologist were identified from the hospital files and contacted by telephone for an interview, and 36 of these were invited for a further thorough assessment. During 12 months follow-up, one out of 15 patients in the placebo group was excluded from further analysis after 28 weeks due to pregnancy, and one after 42 weeks due to study withdrawal and patient's decision to start alternative therapy.</p>", "links"=>[], "tags"=>["immunology", "Mental health", "physiology", "pharmacology", "rheumatology"], "article_id"=>392889, "categories"=>["Physiology", "Ecology", "Mental Health", "Pharmacology", "Immunology"], "users"=>["Øystein Fluge", "Ove Bruland", "Kristin Risa", "Anette Storstein", "Einar K. Kristoffersen", "Dipak Sapkota", "Halvor Næss", "Olav Dahl", "Harald Nyland", "Olav Mella"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0026358.g001"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Study_flow_diagram_/392889", "title"=>"Study flow-diagram.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2011-10-19 00:48:09"}
  • {"files"=>["https://ndownloader.figshare.com/files/722772"], "description"=>"<p>In panel A, the self-reported <i>Fatigue scores</i> were calculated for each patient every second week, from the mean of the four symptoms: Fatigue, Post-exertional exhaustion, Need for rest, Daily functioning. Then the mean values in <i>Fatigue scores</i> for the time intervals during follow-up were plotted. In panel C, the physician-assessed <i>Fatigue scores</i> were calculated from the mean of the same four symptoms, registered by the physician at the visits in the outpatient clinic. In panel B and D, estimated marginal means for self-reported and physician-assessed <i>Fatigue scores</i> during follow-up are shown. The scales on Y-axes were 0–6 (0: Major worsening; 1: Moderate worsening; 2: Slight worsening; 3: No change; 4: Slight improvement; 5: Moderate improvement; 6: Major improvement). The differences in distribution of <i>Fatigue scores</i> during follow-up, between the Rituximab and Placebo groups, were assessed by General Linear Model (GLM) for repeated measures, analysing the effects of time, the interaction time by intervention group, and the overall difference between intervention groups. Below panels C and D, the estimates for differences in mean <i>Fatigue scores</i> between the Rituximab and Placebo groups at the specific time intervals during follow-up, with 95% CI and p-values from the GLM (tests of within-subjects contrasts) are presented. In addition, Holm-Bonferroni step-down adjusted p-values for these time intervals are shown (five comparisons).</p>", "links"=>[], "tags"=>["scores", "rituximab", "placebo", "self-reported"], "article_id"=>393122, "categories"=>["Physiology", "Ecology", "Mental Health", "Pharmacology", "Immunology"], "users"=>["Øystein Fluge", "Ove Bruland", "Kristin Risa", "Anette Storstein", "Einar K. Kristoffersen", "Dipak Sapkota", "Halvor Næss", "Olav Dahl", "Harald Nyland", "Olav Mella"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0026358.g002"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Fatigue_scores_in_Rituximab_and_Placebo_groups_self_reported_and_physician_assessed_/393122", "title"=>"Fatigue scores in Rituximab and Placebo groups, self-reported and physician-assessed.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2011-10-19 00:52:02"}
  • {"files"=>["https://ndownloader.figshare.com/files/722907"], "description"=>"<p>In panels A–J, changes in <i>Fatigue score</i> (black), <i>Cognitive score</i> (red), <i>Pain score</i> (green), <i>“Other symptoms” score</i> (orange), and <i>“CFS overall” score</i> (blue), during 12 months follow-up are shown for the 10 patients in the Rituximab group with significant improvement. The scales on Y-axes were 0–6 (0: Major worsening; 1: Moderate worsening; 2: Slight worsening; 3: No change; 4: Slight improvement; 5: Moderate improvement; 6: Major improvement). Also shown are the B-cell numbers from immunophenotyping of peripheral blood mononuclear cells during follow-up (×10<sup>6</sup>/L).</p>", "links"=>[], "tags"=>["changes", "follow-up", "patients", "rituximab"], "article_id"=>393254, "categories"=>["Physiology", "Ecology", "Mental Health", "Pharmacology", "Immunology"], "users"=>["Øystein Fluge", "Ove Bruland", "Kristin Risa", "Anette Storstein", "Einar K. Kristoffersen", "Dipak Sapkota", "Halvor Næss", "Olav Dahl", "Harald Nyland", "Olav Mella"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0026358.g003"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_CFS_symptom_changes_during_follow_up_for_patients_in_the_Rituximab_group_with_significant_responses_/393254", "title"=>"CFS symptom changes during follow-up for patients in the Rituximab group with significant responses.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2011-10-19 00:54:14"}
  • {"files"=>["https://ndownloader.figshare.com/files/723045"], "description"=>"<p>B-cell numbers from immunophenotyping of peripheral blood during follow-up are shown, for patients in the Placebo group (black, n = 15), patients in the Rituximab group with significant response (red, n = 10), and patients in the Rituximab group with no response (blue, n = 5). The B-cell value zero was substituted by 0.1 (to be able to plot on the log scale). B-lymphocyte counts ×10<sup>6</sup>/L (normal range 110–449). The error bars denote mean ± SEM.</p>", "links"=>[], "tags"=>["immunology", "Mental health", "physiology", "pharmacology", "rheumatology"], "article_id"=>393396, "categories"=>["Physiology", "Ecology", "Mental Health", "Pharmacology", "Immunology"], "users"=>["Øystein Fluge", "Ove Bruland", "Kristin Risa", "Anette Storstein", "Einar K. Kristoffersen", "Dipak Sapkota", "Halvor Næss", "Olav Dahl", "Harald Nyland", "Olav Mella"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0026358.g004"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_B_lymphocytes_during_follow_up_/393396", "title"=>"B-lymphocytes during follow-up.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2011-10-19 00:56:36"}
  • {"files"=>["https://ndownloader.figshare.com/files/723174"], "description"=>"a<p>: p-values from Student's t-test for independent samples.</p>b<p>: two patients in the Rituximab group did not fill in baseline SF-36 form, one with major response and one non-responder.</p>c<p>: range for baseline SF-36 scores is 0–100 (lower score denotes increasing symptoms).</p>d<p>: maximum change (%) in SF-36 scores during follow-up, as compared to baseline. The patients filled in SF-36 forms at baseline and then every month until 10 months after intervention. Five out of 143 forms were missing (not filled in) in the Rituximab group (excluding the two patients with no baseline scheme), and nine out of 161 forms were missing in the Placebo group (one patient withdrawn after 28 weeks due to pregnancy).</p>", "links"=>[], "tags"=>["baseline", "levels", "changes", "patients", "rituximab", "placebo"], "article_id"=>393522, "categories"=>["Physiology", "Ecology", "Mental Health", "Pharmacology", "Immunology"], "users"=>["Øystein Fluge", "Ove Bruland", "Kristin Risa", "Anette Storstein", "Einar K. Kristoffersen", "Dipak Sapkota", "Halvor Næss", "Olav Dahl", "Harald Nyland", "Olav Mella"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0026358.t004"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_SF_36_scores_baseline_levels_0_8211_100_and_maximum_changes_during_follow_up_for_patients_in_the_Rituximab_and_Placebo_groups_/393522", "title"=>"SF-36 scores, baseline levels (0–100) and maximum changes (%) during follow-up, for patients in the Rituximab and Placebo groups.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2011-10-19 00:58:42"}
  • {"files"=>["https://ndownloader.figshare.com/files/723216"], "description"=>"<p>Infusion-related complaints during or the first 24 hours after infusion, and side-effects during 12 months follow-up, in the Rituximab and Placebo groups.</p>", "links"=>[], "tags"=>["complaints", "24", "side-effects", "12", "months", "rituximab", "placebo"], "article_id"=>393559, "categories"=>["Physiology", "Ecology", "Mental Health", "Pharmacology", "Immunology"], "users"=>["Øystein Fluge", "Ove Bruland", "Kristin Risa", "Anette Storstein", "Einar K. Kristoffersen", "Dipak Sapkota", "Halvor Næss", "Olav Dahl", "Harald Nyland", "Olav Mella"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0026358.t005"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Infusion_related_complaints_during_or_the_first_24_hours_after_infusion_and_side_effects_during_12_months_follow_up_in_the_Rituximab_and_Placebo_groups_/393559", "title"=>"Infusion-related complaints during or the first 24 hours after infusion, and side-effects during 12 months follow-up, in the Rituximab and Placebo groups.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2011-10-19 00:59:19"}
  • {"files"=>["https://ndownloader.figshare.com/files/723247"], "description"=>"a<p>: p-values from student's t-test for continuous data, and from Chi-square tests (or Fisher's exact test) for categorical characteristics.</p>b<p>: infectious mononucleosis or unspecific viral infection (6), gastroenteritis (4), respiratory infection (5), urinary infection (1).</p>c<p>: patient's assessment of CFS clinical course the last year before inclusion.</p>d<p>: thyroiditis (2), psoriasis (2), carpal tunnel syndrome (1), diabetes mellitus type I (1), celiac disease (1), juvenile arthritis (1).</p>e<p>: Bechterew's disease, rheumatoid arthritis, psoriasis, Cushing's disease, diabetes mellitus type I, systemic lupus erythematosus, thyroiditis, celiac disease, ulcerative colitis, Sjogren's disease, glomerulonephritis.</p>", "links"=>[], "tags"=>["cfs", "characteristics", "patients", "rituximab", "placebo"], "article_id"=>393598, "categories"=>["Physiology", "Ecology", "Mental Health", "Pharmacology", "Immunology"], "users"=>["Øystein Fluge", "Ove Bruland", "Kristin Risa", "Anette Storstein", "Einar K. Kristoffersen", "Dipak Sapkota", "Halvor Næss", "Olav Dahl", "Harald Nyland", "Olav Mella"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0026358.t001"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Demographic_and_CFS_disease_characteristics_for_patients_in_the_Rituximab_and_Placebo_groups_/393598", "title"=>"Demographic and CFS disease characteristics for patients in the Rituximab and Placebo groups.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2011-10-19 00:59:58"}
  • {"files"=>["https://ndownloader.figshare.com/files/723284"], "description"=>"a<p>: p-values from Student's t-test.</p>b<p>: baseline self-reported symptom scores, generated as the mean (range) of relevant symptoms, as explained in <a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0026358#s2\" target=\"_blank\">Materials and Methods</a> (scale 1–10; 1: no symptom, 5: moderate symptom, 10: very severe symptom, see <a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0026358#pone.0026358.s002\" target=\"_blank\">Figure S1</a>).</p>c<p>: using Taqman SNP Genotyping (Applied Biosystems, assay c_935391_1).</p>d<p>: including four Taqman qPCR and four nested PCR setups (see <a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0026358#pone.0026358.s006\" target=\"_blank\">Table S1</a>).</p>e<p>: performed for nine patients using freshly drawn blood samples. Coculture of patient PBMNC with LNCap prostate cancer cells, and subsequent PCR, as described in <a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0026358#pone.0026358.s001\" target=\"_blank\">Text S1</a>.</p>", "links"=>[], "tags"=>["self-reported", "rnase", "xmrv", "patients", "rituximab", "placebo"], "article_id"=>393632, "categories"=>["Physiology", "Ecology", "Mental Health", "Pharmacology", "Immunology"], "users"=>["Øystein Fluge", "Ove Bruland", "Kristin Risa", "Anette Storstein", "Einar K. Kristoffersen", "Dipak Sapkota", "Halvor Næss", "Olav Dahl", "Harald Nyland", "Olav Mella"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0026358.t002"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Baseline_self_reported_symptom_scores_RNase_L_genotype_and_XMRV_status_for_patients_in_the_Rituximab_and_Placebo_groups_/393632", "title"=>"Baseline self-reported symptom scores, RNase L genotype, and XMRV status, for patients in the Rituximab and Placebo groups.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2011-10-19 01:00:32"}
  • {"files"=>["https://ndownloader.figshare.com/files/723328"], "description"=>"a<p>: p-values from Chi-square statistics.</p>b<p>: One patient was withdrawn from further follow-up registration 28 weeks after inclusion, due to pregnancy. One patient decided to withdraw from the study 42 weeks after inclusion, due to start of alternative therapy. Both patients were allocated to the placebo group and both reported no significant improvement during follow-up. These two were included in the analysis for overall response. Overall response including major and moderate responses, number of patients and proportion (%) with 95% confidence intervals.</p>c<p>: response duration within the 12 months study period, for those achieving a significant response (10 patients in the Rituximab group, and two patients in the Placebo group). In addition, four out of the 10 Rituximab responders had response durations past the formal study period.</p>", "links"=>[], "tags"=>["responses", "rituximab", "placebo", "durations", "patients", "derived", "self-reported", "12", "months"], "article_id"=>393679, "categories"=>["Physiology", "Ecology", "Mental Health", "Pharmacology", "Immunology"], "users"=>["Øystein Fluge", "Ove Bruland", "Kristin Risa", "Anette Storstein", "Einar K. Kristoffersen", "Dipak Sapkota", "Halvor Næss", "Olav Dahl", "Harald Nyland", "Olav Mella"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0026358.t003"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Clinical_responses_in_the_Rituximab_and_Placebo_groups_and_response_durations_for_patients_with_significant_responses_derived_from_self_reported_Fatigue_scores_during_12_months_follow_up_/393679", "title"=>"Clinical responses in the Rituximab and Placebo groups, and response durations for patients with significant responses, derived from self-reported <i>Fatigue scores</i> during 12 months follow-up.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2011-10-19 01:01:19"}

PMC Usage Stats | Further Information

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Relative Metric

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