Fluge, Øystein, Risa, Kristin, Lunde, Sigrid et al. · PloS one · 2015 · DOI
This study tested whether removing B-cells (immune cells) using a drug called rituximab could help ME/CFS patients. Twenty-nine patients received rituximab infusions over 15 months and were followed for 3 years. Eighteen patients (62%) showed lasting improvement in fatigue, with some staying better for over 2 years, though improvements took several months to appear.
This study provides evidence that B-cell depletion may produce sustained clinical benefits in a subgroup of ME/CFS patients, suggesting a potential autoimmune mechanism underlying the disease. The findings support further investigation into immunological pathways and could eventually lead to targeted treatments for patients who don't respond to conventional therapies.
This open-label study cannot definitively prove rituximab causes improvement because there was no control group receiving placebo alongside the treatment phase—expectation effects cannot be excluded. The study does not establish that all ME/CFS patients will benefit, nor does it identify which patient characteristics predict response. Long-term safety beyond 3 years remains unknown.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Fluge, Øystein, Risa, Kristin, Lunde, Sigrid, Alme, Kine, Rekeland, Ingrid Gurvin, Sapkota, Dipak, et al. (2015). B-Lymphocyte Depletion in Myalgic Encephalopathy/ Chronic Fatigue Syndrome. An Open-Label Phase II Study with Rituximab Maintenance Treatment.. PloS one. https://doi.org/10.1371/journal.pone.0129898
BibTeX
@article{mecfsatlas-fluge-2015-lymphocyte-depletion,
author = {Fluge, Øystein and Risa, Kristin and Lunde, Sigrid and Alme, Kine and Rekeland, Ingrid Gurvin and Sapkota, Dipak and Kristoffersen, Einar Kleboe and Sørland, Kari and Bruland, Ove and Dahl, Olav and Mella, Olav},
title = {B-Lymphocyte Depletion in Myalgic Encephalopathy/ Chronic Fatigue Syndrome. An Open-Label Phase II Study with Rituximab Maintenance Treatment.},
journal = {PloS one},
year = {2015},
doi = {10.1371/journal.pone.0129898},
note = {PubMed: 26132314},
url = {https://www.mecfsatlas.com/evidence/fluge-2015-lymphocyte-depletion},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/fluge-2015-lymphocyte-depletion
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