Treatment of 741 Italian patients with chronic fatigue syndrome.

BACKGROUND : Chronic Fatigue Syndrome (CFS) is a distinctive syndrome char - acterized by specific symptoms cluster. CFS mostly affects women and often results in se - vere functional limitation. Its prevalence varies from 0.4 to 2.5% in the general population. In our prior studies on the clinical features of 205 CFS patients we founded immunological and brain abnormalities. In this paper we illustrate our caseload on CFS treatment. PATIENTS AND METHODS: From January 2000 to December 2005, we evaluated all the pa - tients admitted at the CFS Unit of the Aviano Na - tional Cancer Institute, for staging procedures and treatments. Patients not meeting the Fukuda diagnostic criteria were excluded. RESULTS: 250 male and 491 female (median age 35.5 and 39.3 years, respectively) were en - rolled and treated for CFS. As expected, CFS re - sulted from previous infectious disease in all patients. Female patients showed to be more affected by symptoms than male patients. The treatment schedules followed by the patients included nutritional supplements alone, corti - costeroids, antidepressant/sedative drugs, and antiviral/immunoglobulin drugs. Antiviral/ im - munoglobulin drugs achieved the best re - sponse (15.3% positive responses vs. 8.3% negative responses; OR 0.44, CI 0.26-0.74, p = 0.002).The carrying out of 4 or more treatments showed a protective effect (OR 0.46, CI 0.28- 0.77, p = 0.003). This finding was confirmed in the multivariate analysis, adjusted by type of drugs (OR 0.49, CI 0.28-0.84, p = 0.009) and number of treatments carried out (OR 0.51, CI 0.30-0.86, p = 0.01); these two variables were in - dependent. CONCLUSIONS: These findings show that the antiviral/immunoglobulin approach has a longer positive disease free survival in comparison with other approaches. However, CSF still re - mains a difficult disease to be effectively treated.