filgotinib for ME/CFS and RA

A reader asked about this. It is a new drug waiting for approval in the EU. On a Spanish group, it is asserted that:

“This is very encouraging news for patients with ME/CFS, as this drug could show very promising results in this ailment. Specifically, this drug decreases levels of inflammatory cytokines, which are believed to be the main cause of symptoms.”

Unfortunately, there have not been a single study for ME/CFS and this statement is very speculative (in my days, I have seen literally dozens of similar claims which consistently under-delivered or caused additional problems). Wikipedia gives a good summary of what it is and its issues.

The most applicable study is shown below.

Bottom Line

Treatments for Rheumatoid Arthritis have often been tried and used for a subset of ME/CFS. Results were generally mixed. The goal should not be “decreases levels of inflammatory cytokines” but stopping the source of inflammatory cytokines. I believe the dominant source of inflammatory cytokines is a microbiome dysfunction.

You do not want to keep painting the walls to cover up water stains from a leaking roof; you want to fix the roof first.