Roerink, Megan E, Bredie, Sebastian J H, Heijnen, Michael et al. · Annals of internal medicine · 2017 · DOI
Researchers tested whether a drug called anakinra, which reduces inflammation in the body, could help reduce fatigue in women with ME/CFS. Over 4 weeks, patients received either anakinra injections or placebo (dummy injections), and both groups were followed for an additional 20 weeks. The drug did not significantly improve fatigue or other symptoms compared to placebo, though some patients experienced injection site reactions.
This study directly tests the hypothesis that IL-1-mediated inflammation drives ME/CFS fatigue, a theory supported by some immunological findings. A negative result suggests that peripheral IL-1 inhibition alone is insufficient to treat ME/CFS, which has implications for future therapeutic strategies and understanding of disease pathophysiology.
This study does not prove that inflammation plays no role in ME/CFS—only that blocking IL-1 peripherally for 4 weeks does not reduce fatigue. The findings do not exclude central nervous system IL-1 involvement, other cytokine pathways, or the importance of inflammation in disease onset or maintenance. Additionally, heterogeneity in symptom duration and lack of restriction to postinfectious cases may have obscured effects in subgroups.
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
Roerink, Megan E, Bredie, Sebastian J H, Heijnen, Michael, Dinarello, Charles A, Knoop, Hans, & Van der Meer, Jos W M (2017). Cytokine Inhibition in Patients With Chronic Fatigue Syndrome: A Randomized Trial.. Annals of internal medicine. https://doi.org/10.7326/M16-2391
BibTeX
@article{mecfsatlas-roerink-2017-cytokine-inhibition-2,
author = {Roerink, Megan E and Bredie, Sebastian J H and Heijnen, Michael and Dinarello, Charles A and Knoop, Hans and Van der Meer, Jos W M},
title = {Cytokine Inhibition in Patients With Chronic Fatigue Syndrome: A Randomized Trial.},
journal = {Annals of internal medicine},
year = {2017},
doi = {10.7326/M16-2391},
note = {PubMed: 28265678},
url = {https://www.mecfsatlas.com/evidence/roerink-2017-cytokine-inhibition-2},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-25. https://www.mecfsatlas.com/evidence/roerink-2017-cytokine-inhibition-2
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