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Myalgia Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)Phase 2NCT06952413

Study of the Efficacy and Safety for Rituximab in Myalgia Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)

A Phase 2 study testing Rituximab(Genetical Recombination) in people with Myalgia Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), run by National Center of Neurology and Psychiatry, Japan at 1 site in Japan.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

The efficacy and safety of rituximab on ME/CFS symptoms after administration to patients with myalgic encephalomyelitis/chronic fatigue syndrome will be compared in an exploratory, placebo-controlled, double-blind fashion. Read more about this study

Who is it for?
Ages 18 to 65 years
What is being tested?
Rituximab(Genetical Recombination)
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
30 participants
Where
1 siteJapan
Study dates
9 Apr 2025to 31 Oct 2027
Phase
Phase 2
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 65 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patients diagnosed with ME/CFS who meet the Canadian criteria by a physician.
  • Patients with a severity score of 4 or higher on the Performance Status (PS) based ME/CFS severity classification by the Ministry of Health, Labour and Welfare Research Group
  • Patients who are between 18 and 65 years of age at the time of obtaining written consent
  • Patients who can be hospitalized (hospitalized from the day before administration and discharged the day after administration) at the time of the first dose of each of the primary and secondary evaluation periods
  • Patients whose written consent has been obtained

Who cannot join

  • Patients with a history of severe hypersensitivity or anaphylactic reactions to components of rituximab or products derived from mouse protein
  • Patients whose cardiopulmonary function is judged by the treating physician to be not maintained
  • Patients complaining of fatigue that does not meet the diagnostic criteria for ME/CFS
  • Patients found to have other medical conditions that may cause symptoms
  • Patients who are pregnant, lactating, or have a positive pregnancy test (serum human chorionic gonadotropin test) at the time of enrollment
  • Patients with coexisting or pre-existing malignant tumors (excluding basal cell carcinoma of the skin and cervical dysplasia)
Show all 21Show fewer
  • Patients with coexisting or pre-existing severe immune system diseases (excluding autoimmune diseases such as thyroiditis and type 1 diabetes)
  • Patients with a history of systemic immunosuppressive therapy (e.g., immunoglobulin therapy, azathioprine, cyclosporine, mycophenolate mofetil, etc.) within 1 year, a history of receiving drugs such as monoclonal antibodies acting on the immune system (e.g., anti-CD20 antibody products including rituximab), or a history of comorbidities requiring treatment with immunosuppressive drugs Patients with comorbidities requiring treatment with immunosuppressive agents (excluding treatment with low-dose steroids of 5 mg /day or less)
  • Patients who have started alternative medicine (reference: acupuncture, moxibustion, and Japanese warm therapy) within 12 weeks prior to the start of treatment with the investigational drug.
  • Patients with severe endogenous (primary) depression
  • Patients with a neutrophil count <1.5*103/microliter and platelet count <10.0*104/microliter on blood test
  • Patients with impaired renal function (serum creatinine level > 1.5 times the upper limit of the reference value at the institution)
  • Patients with impaired hepatic function (serum bilirubin, Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT) levels exceeding 1.5 times the upper limit of the reference value of the institution)
  • Patients infected with Human Immunodeficiency Virus (HIV)
  • Patients who test positive for at least one of Hepatitis B surface (HBs) antigen, HBs antibody, Hepatitis B core (HBc) antibody, or Hepatitis C virus (HCV) antibody.
  • However, patients who meet the following conditions (1) and (2) may be registered.
  • Patients who are positive for HBs or HBc antibodies and whose HBV-DNA quantification is confirmed to be negative (less than detection sensitivity) and for whom appropriate monitoring, etc. can be conducted in accordance with the Guidelines for Hepatitis B Treatment edited by the Japan Society of Hepatology.
  • For patients with positive HCV antibody, when HCV-RNA quantification is negative (less than detection sensitivity)
  • Patients who do not have the ability to comply with the study protocol
  • Patients who have participated in other clinical trials or clinical studies (except for observational studies without intervention) within 16 weeks prior to obtaining consent
  • Other patients who are judged by the investigator or subinvestigator (hereinafter referred to as investigator) to be inappropriate to participate in this clinical trial.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Takami Ishizuka, PhD contact

+081-42-341-2711

tmc-crso@ncnp.go.jp

Japan1 site, 1 recruiting
  • National Center of Neurology and Psychiatry

    Kodaira, Tokyo, 187-8551

    Takami Ishizuka, PhD, +81-42-341-2711, tmc-crso@ncnp.go.jp

    Tomoko Okamoto, MD

    Recruiting

Other trials in Japan

About this study

Official title: An Exploratory, Placebo-controlled, Double-blind, Phase II Study of the Efficacy and Safety for Rituximab (Genetical Recombination) in Myalgia Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)

The efficacy and safety of rituximab on ME/CFS symptoms after administration to patients with myalgic encephalomyelitis/chronic fatigue syndrome will be compared in an exploratory, placebo-controlled, double-blind fashion. In the subsequent secondary evaluation period, subjects who received rituximab in the primary evaluation period will receive placebo, and the timing and duration of rituximab's effect will be explored throughout the entire evaluation period. Subjects who received placebo during the primary evaluation period will receive rituximab during the secondary evaluation period to explore changes in endpoints before and after switching from placebo to rituximab in the same subjects.

Read the detailed description

The efficacy and safety of rituximab (genetical recombination), a CD20 antibody, on ME/CFS symptoms after administration to patients with myalgic encephalomyelitis/chronic fatigue syndrome will be compared in an exploratory, placebo-controlled, double-blind fashion. In the subsequent secondary evaluation period, subjects who received rituximab in the primary evaluation period will receive placebo, and the timing and duration of rituximab's effect will be explored throughout the entire evaluation period. Subjects who received placebo during the primary evaluation period will receive rituximab during the secondary evaluation period to explore changes in endpoints before and after switching from placebo to rituximab in the same subjects.

Being tested
Rituximab(Genetical Recombination), Placebo
Medical subject headings
Fatigue Syndrome, Chronic

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Rituximab(Genetical Recombination)Drug

    Subjects will be assigned to the rituximab pre-treatment group or placebo pre-treatment group and will receive the study drug (rituximab actual or rituximab placebo) intravenously four times at weekly intervals during the first three weeks of the primary and secondary evaluation periods.

  • PlaceboDrug

    Subjects will be assigned to the rituximab pre-treatment group or placebo pre-treatment group and will receive the study drug (rituximab actual or rituximab placebo) intravenously four times at weekly intervals during the first three weeks of the primary and secondary evaluation periods.

Study groups in NCT06952413
Study groupRoleWhat they receive
Rituximab(Genetical Recombination)Active comparatorNot described
Receives: Drug: Rituximab(Genetical Recombination)
PlaceboPlacebo comparatorNot described
Receives: Drug: Placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Improvement rate

    Percentage of cases in which the severity score of ME/CFS based on PS by the MHLW research group improved by 1 or more compared to that before the start of study drug administration (week 0)

    Measured: From Baseline to the end of treatment at 24 weeks

Secondary outcomes (29)
  1. Percentage of patients whose MHLW-PS-based ME/CFS severity score improved by 1 or more at each evaluation point (improvement rate) compared to that before the start of treatment with the investigational drug (week 0).

    Measured: At 4-week intervals from Baseline up to Week 48

  2. The amount of change in the severity score of ME/CFS based on PS by the MHLW Research Group at each assessment point from that before the start of treatment with the investigational drug (week 0)

    Measured: At 4-week intervals from Baseline up to Week 48

  3. Proportion of awake time spent in supine position (%),Proportion of awake time spent in sitting position (%)

    Changes in proportions will be aggregated.

    Measured: At 4-week intervals from Baseline up to Week 48

  4. Duration of standing and activity (hours)

    Changes in time will be aggregated.

    Measured: At 4-week intervals from Baseline up to Week 48

  5. Fatigue during rest and lying position

    Patients will be asked to report the level of fatigue they feel even while lying down, and changes in their fatigue levels will be aggregated.

    Measured: At 4-week intervals from Baseline up to Week 48

  6. Records on exertion and Post-Exertional Malaise (PEM)

    Patients will be asked to describe the specific activities they perform and the exhaustion they experience afterward, and a summary table will be created.

    Measured: At 4-week intervals from Baseline up to Week 48

  7. Assessment of fatigue during physical activity

    Patients will be asked to report the level of fatigue they experience during physical activity in daily life, and changes in fatigue levels will be aggregated.

    Measured: At 4-week intervals from Baseline up to Week 48

  8. Evaluation based on Fatigue Score

    Patients will be asked to complete the Fatigue Score questionnaire, and changes in the score will be aggregated.

    Measured: At 2-week intervals from Baseline up to Week 48

  9. SF-36

    Changes in scores obtained from the SF-36 questionnaire will be assessed to evaluate patients' quality of life.

    Measured: At 12-week intervals from Baseline up to Week 48

  10. COMPASS31

    Changes in scores obtained from the COMPASS31 questionnaire will be assessed to evaluate patients' autonomic symptoms.

    Measured: At 12-week intervals from Baseline up to Week 48

  11. Pittsburgh Sleep Quality Index (PSQI)

    Changes in scores obtained from the PSQI questionnaire will be assessed to evaluate patients' sleep quality.

    Measured: At 12-week intervals from Baseline up to Week 48

  12. Pain intensity

    Pain intensity will be assessed using the Visual Analogue Scale (VAS)

    Measured: At 12-week intervals from Baseline up to Week 48

  13. Grip strength

    Patients' grip strength will be measured, and changes in the measurements will be aggregated.

    Measured: At 12-week intervals from Baseline up to Week 48

  14. Analysis of the gut microbiota

    samples collected from patients will be analyzed, and the composition of the gut microbiota will be aggregated.

    Measured: At 24-week intervals from Baseline up to Week 48

  15. Brain imaging evaluation (Magnetic Resonance Imaging (MRI) of the head, Single Photon Emission Computed Tomography (SPECT) of cerebral blood flow)

    Findings from imaging will be aggregated.

    Measured: At 24-week intervals from Baseline up to Week 48

  16. Immune biomarker analysis (qPCR)

    qPCR will be measured, and changes in their levels will be aggregated.

    Measured: At 24-week intervals from Baseline up to Week 48

  17. Immune biomarker analysis (anti-autonomic receptor antibody analysis)

    Quantify the level of anti-autonomic receptor antibodies will be measured, and changes in their levels will be aggregated.

    Measured: At 24-week intervals from Baseline up to Week 48

  18. Immune biomarker analysis (immune cell subfractionation analysis)

    The subsets of immune cells will be measured, and changes in the levels will be aggregated.

    Measured: At 24-week intervals from Baseline up to Week 48

  19. Metabolome analysis

    A detailed characterization of the patients' metabolome at baseline will be conducted.

    Measured: At Baseline

  20. Adverse events

    The number of adverse events will be aggregated.

    Measured: From Baseline up to Week 48

  21. Vital signs (body temperature)

    Summary statistics of vital signs will be calculated to monitor changes over time.

    Measured: Assessments will be conducted at baseline and at Weeks 1, 2, 3, 4, 8, 12, 24, 25, 26, 27, 28, 32, 36, and 48

  22. Vital signs (blood pressure)

    Summary statistics of vital signs will be calculated to monitor changes over time.

    Measured: Assessments will be conducted at baseline and at Weeks 1, 2, 3, 4, 8, 12, 24, 25, 26, 27, 28, 32, 36, and 48

  23. Vital signs (pulse rate)

    Summary statistics of vital signs will be calculated to monitor changes over time.

    Measured: Assessments will be conducted at baseline and at Weeks 1, 2, 3, 4, 8, 12, 24, 25, 26, 27, 28, 32, 36, and 48

  24. Serum immunoglobulins (IgG)

    Summary statistics of serum immunoglobulins will be calculated to monitor changes over time.

    Measured: At 4-week intervals from Baseline up to Week 48

  25. Serum immunoglobulins (IgM)

    Summary statistics of serum immunoglobulins will be calculated to monitor changes over time.

    Measured: At 4-week intervals from Baseline up to Week 48

  26. Serum immunoglobulins (IgA)

    Summary statistics of serum immunoglobulins will be calculated to monitor changes over time.

    Measured: At 4-week intervals from Baseline up to Week 48

  27. Rituximab concentration of the blood plasma

    Rituximab concentration of the blood plasma

    Measured: Assessments will be conducted at baseline and at Weeks 1, 2, 3, 4, 12, 24, 25, 26, 27, 28, 36, and 48

  28. Blood drug concentration Anti-Drug Antibody (ADA)

    Summary statistics of ADA will be calculated to monitor changes over time.

    Measured: Assessments will be conducted at baseline and at Weeks 4, 12, 24, 28, 36, and 48.

  29. B cells (CD19/CD20 positive cells) and T cells (CD3/CD4/CD8 positive cells)

    Summary statistics of B cells and T cells will be calculated to monitor changes over time.

    Measured: Assessments will be conducted at baseline and at Weeks 1, 12, 24, 25, 36, and 48.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted30 Apr 2025
  2. Study start9 Apr 2025
  3. Primary completion30 Sep 2026 (estimated)
  4. Study completion31 Oct 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Crossover
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
30 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06952413
Sponsor's protocol ID
IDEC-C2B8-MC
Status last verified
Apr 2025
First submitted
9 Apr 2025
Last updated
30 Apr 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Rituximab(Genetical Recombination) in people with Myalgia Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), run by National Center of Neurology and Psychiatry, Japan at 1 site in Japan.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 21 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 30 Apr 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Japan. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Takami Ishizuka, PhD (+081-42-341-2711, tmc-crso@ncnp.go.jp), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Improvement rate (time frame: From Baseline to the end of treatment at 24 weeks). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 30 Apr 2025.

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