Solving ME/CFS

Treatment trials

1028 treatment trials in ME/CFS (370), long COVID (618) or both (40), with design, size and result. Long COVID trials are included when they target fatigue, crashes after exertion, cognition or autonomic symptoms.

Built 2026-10-29 from ClinicalTrials.gov, ISRCTN, EU CTIS and Europe PMC · Download as JSON

The better a trial is designed, the less often it finds a benefit. Most uncontrolled trials report one; most large blinded trials do not. Of 255 trials that finished more than a year ago, we found no published result.

Uncontrolled (single arm, open label)86% positive · n=158
Randomised, not blinded70% positive · n=185
Blinded, placebo or sham36% positive · n=177
Blinded, 100 or more people15% positive · n=44

PositiveMixedNo benefitHarm

Figure 1. Result by trial design. 520 trials whose efficacy result we read in the abstract or posted results. "Positive" means the authors reported a benefit on the primary outcome; it says nothing about bias. Traditional Chinese medicine and acupuncture trials, mostly unblinded, account for many of the uncontrolled positives.
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ME/CFSLong COVID or both

Figure 2. Trials by start year (or first publication, where unregistered).
Behavioural/rehab396
Other216
Supplement120
Device/neuromodulation88
Immunomodulator80
Metabolic/mitochondrial53
Autonomic/vasoactive28
Antiviral22
Microbiome13
Apheresis/immunoadsorption12

PositiveMixedNo benefitHarmNot finishedFinished, no result found

Figure 3. Trials by type of treatment and result. Bar length is the number of trials.

Large blinded trials

Placebo- or sham-controlled trials of 100 or more people, with a result.

TrialPopulationnResultSummary
RECOVER-VITALlong COVID951No benefitRECOVER-VITAL: nirmatrelvir/ritonavir 15 or 25 d vs placebo (n=959; cognitive, autonomic, exercise phenotypes): no benefit in any phenotype
Prospektalong COVID676PositiveProspekta vs placebo for post-COVID asthenia (n=676): FSS fell 16.5 vs 14.0 (p=0.0016); small absolute difference; industry-sponsored
galantamineME/CFS434No benefitGalantamine (3 doses) vs placebo (n=434): no benefit on any outcome
distant healingME/CFS409No benefitEUHEALS distant healing vs no healing, partially blinded (n=409): no effect on mental or physical health
REVIVEboth399MixedFluvoxamine and metformin vs placebo, adaptive (n=399): fluvoxamine reduced fatigue (day 60 and 90) and improved QoL; metformin no benefit
metformin / ursodeoxycholic acidlong COVID396No benefitMetformin or ursodeoxycholic acid vs placebo 2 weeks (n=396, Korea): no improvement in recovery
colchicinelong COVID346No benefitColchicine vs placebo (n=346, India): no improvement in 6MWT, respiratory function or inflammation at 52 weeks
cognitive rehabilitation + transcranial stimulation/neurofeedbacklong COVID328No benefitRECOVER-NEURO: BrainHQ, PASC-CoRE cognitive rehab and tDCS vs controls (n=328): no benefit of any intervention on cognition
CBT/psychological therapyME/CFS300MixedVideo CBSM vs health information: medium-large benefits only in high-PEM subgroup, none in low-PEM
CONNeCTME/CFS282MixedCoQ10 200 mg + NADH 20 mg vs placebo for 12 weeks (n=207 analysed): within-group falls in cognitive fatigue and FIS-40 and better SF-36 and sleep on active; abstract reports within-group changes, not clear between-group superiority
ESSORlong COVID272No benefitLAU-7b (fenretinide) vs placebo (n=272): no SF-36 PCS improvement at week 12
CBT/psychological therapy + pacing/energy managementME/CFS240MixedFITNET-NHS: remote CBT vs activity management in paediatric ME/CFS (n=~240): better physical function and school attendance at 6 months; limited sustained effect, not cost-effective
herbal/TCMME/CFS235PositiveCompound Ciwujia granules vs placebo (TCM, n=235): fatigue scores improved significantly at 6 weeks
acupuncture/manual therapyME/CFS210MixedAcupuncture vs moxibustion (active comparison): different short- vs long-term HRV effects; no placebo arm
temelimablong COVID203No benefitTemelimab (anti-HERV-W Env) vs placebo (n=203): no improvement in fatigue
(deu)pirfenidonelong COVID177No benefitDeupirfenidone (n=185): 6MWD improved in both arms; no difference vs placebo
low-dose naltrexoneboth160No benefitLDN up to 4.5 mg vs placebo for 16 wk (n=160): no difference in fatigue (FSS), pain, symptoms, step count or QoL
GkoCistME/CFS159MixedCistanche+ginkgo product (n=159): symptom improvement vs placebo but effect size described as trivial
online occupational therapylong COVID158MixedOnline occupational therapy (interactive vs video vs control, n=158): all groups improved cognition; exploratory efficacy
QureME/CFS155MixedQure: doxycycline or CBT vs placebo in Q-fever fatigue syndrome (n=155): posted CIS fatigue CBT 31.6, doxycycline 40.8, placebo 37.8; no between-group statistics posted; CBT numerically lowest, doxycycline no better than placebo
STOP-PASClong COVID155No benefitSTOP-PASC: nirmatrelvir/ritonavir 15 d vs placebo/r (n=155): safe, no benefit on core symptoms
PYCNOVIDlong COVID153No benefitPYCNOVID: Pycnogenol 200 mg vs placebo (n=153): no difference in EQ-VAS; both groups improved
RituxMEME/CFS151No benefitRituxME (n=151): response 26% rituximab vs 35% placebo (P=0.22); no difference in fatigue over 24 months
acupunctureME/CFS150PositiveAcupuncture vs sham (n=~150, single-blind): moderate reductions in physical and mental fatigue
vortioxetinelong COVID149MixedVortioxetine vs placebo (n=149): DSST cognition change 0.33 vs 0.18, not significant unadjusted; depression and HRQoL improved in paper

Finished, no result found

The largest of 255 trials that completed more than 12 months ago with no posted or published result we could find. Some will have reported somewhere we missed; tell us.

TrialPopulationnCompletedSponsor
breathing/respiratory traininglong COVID22682023-07Mayo Clinic
exercise/rehabilitationlong COVID20002022-09The Opole University of Technology
sequelaelong COVID20002022-10All Natural Medicine Clinic, LLC
BEACONlong COVID16082025-05
LISTENlong COVID5542023-07
vitamins/mineralsboth5282025-03ClinAmygate
RECLAIMlong COVID4602025-12University Health Network, Toronto
exercise/rehabilitationlong COVID4122022-12PHARMENTERPRISES LLC
exercise/rehabilitationlong COVID4002023-07Majmaah University
brain-retraining programmeboth3602024-12Helsinki University Central Hospital
PreVitaCOVboth3212025-01Wuerzburg University Hospital
MINIRICOlong COVID3102025-06University Hospital, Akershus
SOMA.COVlong COVID2692025-06
D-riboseME/CFS2572009-09Kona Research Center
COVIVAlong COVID2502024-09Uniformed Services University of the Health Sciences
microbiome therapylong COVID2402023-12Sheffield Hallam University
CBT/psychological therapyME/CFS2342015-05Norwegian University of Science and Technology
PROLIFIClong COVID2192024-11Karolinska Institutet
Inactive Kinetic Oscillation Stimulation (KOS); Active Kinetic Oscillation Stimulation (KOS)ME/CFS2002020-06Karolinska University Hospital
A novel online program for fatigue; a feasibility studyME/CFS2002022-03

Largest randomised trials still running

TrialPopulationnDueSponsor
RECLAIMlong COVID12502027-12Janneke van de Wijgert
LOCITTlong COVID10002026-12Scripps Translational Science Institute
RISElong COVID6322027-07Huashan Hospital
PERCEIVE-Outreach Disease Management Programlong COVID5772029-04University of Tasmania
REVERSE-LClong COVID5502027-07Wes Ely
vagus nerve stimulationlong COVID5462025-12Leidos Life Sciences
AFTERMATHlong COVID5202027-03Unity Health Toronto
CBT/psychological therapylong COVID4002027-04University of California, Davis
LONG-CALMlong COVID4002027-11Columbia University
SPACO+long COVID4002026-10Centre Hospitalier Universitaire de Saint Etienne
D.01.02.3.03long COVID400Dr. Willmar Schwabe GmbH & Co. KG
2023-02978long COVID376Goethe University Frankfurt
cognitive rehabilitationlong COVID3742027-01Fundación Cardioinfantil Instituto de Cardiología
exercise/rehabilitationlong COVID3602026-05Duke University
(deu)pirfenidone + JAK inhibitorlong COVID3482027-12Douglas D. Fraser

All trials

TreatmentPopulationDesignnYearResult

Results marked with * were classified from the registry or title without reading an abstract. Classes and model steps are assigned by keyword. Corrections to hello@solvingmecfs.org.