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Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)IMPACTNCT07529197

Observational Study on Immunoadsorption (IA) in Patients With Autoantibody-Positive Post-Infectious ME/CFS

An observational study of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and ME/CFS Following COVID-19, run by Charite University, Berlin, Germany at 1 site in Germany.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a severe, often infection-triggered disease characterized by debilitating fatigue and post-exertional malaise lasting over 14 hours, along with pain, cognitive impairment, autonomic dysfunction, and sleep disturbances. Read more about this study

Who is it for?
Ages 18 to 65 years
What is being tested?
IA with TheraSorb ® column (Miltenyi)
Type of treatment
Medical device
How many people
50 participants
Where
1 siteGermany
Study dates
11 Mar 2026to 31 Dec 2027
Phase
Observational
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 65 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: Patients presenting to our outpatient clinic who meet the CCC for ME/CFS and show detectable autoantibodies are offered IA as part of routine care. Those undergoing IA are invited to participate in this observational study. Post-COVID patients fulfilling the CCC criteria are also eligible for IA and study inclusion.

Who may be able to join

  • Patients aged 18-65 years who are able to give informed consent and have: i) ME/CFS diagnosed according to the CCC, with exertion intolerance and symptom worsening (post exertional malaise = PEM) lasting at least 14 hours and ii) Significant functional impairment with a Bell Disability Score < 60
  • Presence of autoantibodies (adrenergic or antineuronal antibodies)
  • Undergoing IA with the TheraSorb® column over 5 days
  • Written informed consent provided by the patient
  • Health insurance coverage

Who cannot join

  • Lack of willingness to store pseudonymized disease data as part of the study
  • Pregnancy
  • Presence of other conditions that prevent a definite ME/CFS diagnosis (e.g., heart failure, lung disease, severe depression, cancer)
  • Acute infection (COVID, HIV, hepatitis)
  • Severe fatigue disease with bedriddenness (Bell Disability Score < 30)

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Elisa A Stein, Dr. contact

+49 450 624354

elisa.stein@charite.de

Germany1 site, 1 recruiting
  • Charité - Universitätsmedizin Berlin

    Berlin, State of Berlin, 10117

    Carmen Scheibenbogen, Prof. Dr., +49 30 450 524103, carmen.scheibenbogen@charite.de

    Recruiting

Other trials in Germany

About this study

Official title: Observational Study on Immunoadsorption (IA) in Patients With Autoantibody-Positive Post-Infectious Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a severe, often infection-triggered disease characterized by debilitating fatigue and post-exertional malaise lasting over 14 hours, along with pain, cognitive impairment, autonomic dysfunction, and sleep disturbances. Around 10% of patients after mild or moderate COVID-19 develop Post-COVID Syndrome (PCS), and some meet ME/CFS criteria after six months. No causal treatment exists for ME/CFS or PCS; current approaches are symptomatic and rehabilitative. Given the high and increasing number of affected patients, there is an urgent need for evidence-based, standardized therapies.

Immunoadsorption (IA) is an established treatment for several autoimmune diseases. The first study demonstrating successful IA use in PCS-associated ME/CFS was published by our group in 2024. Earlier proof-of-concept studies (2018, 2020) in infection-related ME/CFS also showed symptomatic improvement in most patients.

Read more

Hypothesis:

Antibody depletion through IA improves symptoms in the majority of patients with autoantibody-positive ME/CFS and is associated with altered memory B-cell profiles before treatment.

Objective:

To observe and document symptom progression in 50 ME/CFS or PCS patients undergoing IA, and to examine whether changes in memory B-cells before treatment are linked to therapeutic response.

The study is conducted as a non-interventional observational study. IA using the TheraSorb® column (Miltenyi) is performed within its approved clinical application.

Read the detailed description

Patients presenting to our outpatient clinic who meet the Canadian Consensus Criteria (CCC) for ME/CFS and show detectable autoantibodies are offered IA as part of routine care. Those undergoing IA are invited to participate in this observational study. Post-COVID patients fulfilling the CCC are also eligible for IA and study inclusion.

IA is performed independently of the study at the Diamedikum Potsdam. The standard clinical schedule includes five outpatient sessions on days 1, 2, 4, 6, and 8. This procedure follows routine clinical practice and is not influenced by study participation.

At study inclusion, all patients undergo baseline assessments including routine laboratory tests, immunoglobulins, autoantibodies, and biomarkers, with a total of 50 ml of blood collected. Additional diagnostic workup is performed as clinically indicated. The diagnosis of ME/CFS is confirmed using the CCC.

Health status and symptom severity are documented using validated questionnaires: SF-36 (Physical Function subscale), work ability (past 12 months), weighted CCC symptom score, Chalder Fatigue Questionnaire, and Bell Disability Scale. These are completed monthly for 12 months after treatment. To reduce participant burden, questionnaires are mailed to patients for home completion.

Further clinical and laboratory assessments are conducted before IA and at 2- and 6-months post-treatment: i) Handgrip strength, ii) NASA Lean Test, and iii) Blood sampling.

The total study duration per participant is 12 months after IA.

This is a non-interventional observational study following patients with ME/CFS or PCS undergoing IA using the TheraSorb® Immunoadsorption system (Miltenyi) within its approved indication.

Evidence on the effectiveness of IA for ME/CFS including PCS exists only from clinical studies. This observational study aims to provide data to support a future randomized controlled trial (RCT).

Being tested
IA with TheraSorb ® column (Miltenyi)
Keywords
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), Post-COVID Syndrome (PCS), Immunoadsorption (IA), SF-36 Physical Function (PF)
Medical subject headings
Fatigue Syndrome, Chronic

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • IA with TheraSorb ® column (Miltenyi)Device

    Also called TheraSorb - Ig omni 1/5 adsorber, Immunoadsorption (IA)

    IA cycle is 5 days (1-2-4-6-8); the procedure follows routine clinical practice.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Improvement in Physical Function (PF) as measured by the Short Form 36 Health Survey Questionnaire (SF-36)

    The SF-36 is an established and widely used health-related quality of life measure. The PF domain asks patients to report limitations on ten mobility activities, such as walking specified distances, carrying groceries, and bathing or dressing. Scores are weighted and transformed into a scale ranging from 0 (greatest possible health restrictions, i.e., severe disability) to 100 (no health restrictions). An intra-patient change of 10 points in SF-36-PF from baseline to week four is considered clinically meaningful.

    Measured: 8 weeks after first IA

Secondary outcomes (8)
  1. Improvement in ability to work in daily hours

    Number of patients with an intra-patient change in his/her/their ability to work in daily hours from 6 months before first IA to 12 months after last IA.

    Measured: before first IA; 3 and 6 months after last IA

  2. Improvement in hand grip strength

    Intra-patient change in hand grip strength from baseline to follow-up points assessed using the Handgrip-Muscle-Fatigue Test.

    Measured: 8 weeks after first IA

  3. Improvement in physical and mental fatigue as measured by the Chalder Fatigue Scale

    The Chalder Fatigue Scale measures the extent and severity of tiredness and has been used in multiple randomized trials of behavioral interventions in patients with ME/CFS. Each of the 11 items is answered on a 4-point scale with an overall score ranging from 0 (asymptomatic) to 33 (maximum symptomology). Intra-patient change in physical and mental fatigue from baseline to follow-up points will be documented as indexed by the Chalder Fatigue Scale.

    Measured: 8 weeks after first IA; 3 and 6 months after last IA

  4. Improvement in symptoms of ME/CFS as measured by Canadian Consensus Criteria (CCC) Symptom Score

    The CCC Symptom Score quantifies ME/CFS symptoms. Its score ranges from 1 (no symptoms) to 10 (extreme symptoms). Intra-patient change in ME/CFS symptoms from baseline to follow-up points will be documented as indexed by the CCC Symptom Score.

    Measured: 8 weeks after first IA; 3 and 6 months after last IA

  5. Improvement in symptoms of autonomic dysfunction as measured by the Composite Autonomic Symptom Score (COMPASS-31)

    The COMPASS-31 is a refined, internally consistent, and markedly abbreviated quantitative measure of autonomic symptoms. It is based on the original Autonomic Symptom Profile (ASP) and COMPASS, applies a much-simplified scoring algorithm, and is suitable for widespread use in autonomic research and practice. It evaluates six domains of autonomic function: orthostatic intolerance, vasomotor, secretomotor, gastrointestinal, bladder, and pupillomotor domains. The score ranges from 0 (no symptoms) to 100 (strong autonomic dysfunction). Intra-patient change in autonomic dysfunction from baseline to follow-up points will be documented as indexed by the COMPASS-31.

    Measured: 8 weeks after first IA; 3 and 6 months after last IA

  6. Decrease in ß2R autoantibodies and soluble biomarkers of disease

    Intra-patient change in ß2R autoantibodies and soluble biomarkers of disease from baseline to follow-up points assessed.

    Measured: 8 weeks after first IA

  7. Correlation of treatment response with memory B-cells

    Associations of intra-patient change in symptoms and profile or levels of memory B-cells from baseline to follow-up points.

    Measured: 8 weeks after first IA

  8. Verification of tolerability

    Number of patients tolerating the IA treatment.

    Measured: 8 weeks after last IA

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted14 Apr 2026
  2. Study start11 Mar 2026
  3. Primary completion30 Jun 2027 (estimated)
  4. Study completion31 Dec 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
50 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07529197
Sponsor's protocol ID
IMPACT
Acronym
IMPACT
Status last verified
Apr 2026
First submitted
31 Mar 2026
Last updated
14 Apr 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Tolle M, Freitag H, Antelmann M, Hartwig J, Schuchardt M, van der Giet M, Eckardt KU, Grabowski P, Scheibenbogen C. Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Efficacy of Repeat Immunoadsorption. J Clin Med. 2020 Jul 30;9(8):2443. doi: 10.3390/jcm9082443.

    PubMed 32751659
  • Scheibenbogen C, Loebel M, Freitag H, Krueger A, Bauer S, Antelmann M, Doehner W, Scherbakov N, Heidecke H, Reinke P, Volk HD, Grabowski P. Immunoadsorption to remove ss2 adrenergic receptor antibodies in Chronic Fatigue Syndrome CFS/ME. PLoS One. 2018 Mar 15;13(3):e0193672. doi: 10.1371/journal.pone.0193672. eCollection 2018.

    PubMed 29543914
  • Stein E, Heindrich C, Wittke K, Kedor C, Rust R, Freitag H, Sotzny F, Kruger A, Tolle M, Grabowski P, Scheibenbogen C, Kim L. Efficacy of repeated immunoadsorption in patients with post-COVID myalgic encephalomyelitis/chronic fatigue syndrome and elevated beta2-adrenergic receptor autoantibodies: a prospective cohort study. Lancet Reg Health Eur. 2024 Dec 12;49:101161. doi: 10.1016/j.lanepe.2024.101161. eCollection 2025 Feb.

    PubMed 39759581
  • Sotzny F, Filgueiras IS, Kedor C, Freitag H, Wittke K, Bauer S, Sepulveda N, Mathias da Fonseca DL, Baiocchi GC, Marques AHC, Kim M, Lange T, Placa DR, Luebber F, Paulus FM, De Vito R, Jurisica I, Schulze-Forster K, Paul F, Bellmann-Strobl J, Rust R, Hoppmann U, Shoenfeld Y, Riemekasten G, Heidecke H, Cabral-Marques O, Scheibenbogen C. Dysregulated autoantibodies targeting vaso- and immunoregulatory receptors in Post COVID Syndrome correlate with symptom severity. Front Immunol. 2022 Sep 27;13:981532. doi: 10.3389/fimmu.2022.981532. eCollection 2022.

    PubMed 36238301
  • Kedor C, Freitag H, Meyer-Arndt L, Wittke K, Hanitsch LG, Zoller T, Steinbeis F, Haffke M, Rudolf G, Heidecker B, Bobbert T, Spranger J, Volk HD, Skurk C, Konietschke F, Paul F, Behrends U, Bellmann-Strobl J, Scheibenbogen C. A prospective observational study of post-COVID-19 chronic fatigue syndrome following the first pandemic wave in Germany and biomarkers associated with symptom severity. Nat Commun. 2022 Aug 30;13(1):5104. doi: 10.1038/s41467-022-32507-6.

    PubMed 36042189
  • Scheibenbogen C, Kedor C, Behrends U. ME/CFS, Der niedergelassene Arzt, 12/2020

Questions about this trial

What is this clinical trial studying?

An observational study of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and ME/CFS Following COVID-19, run by Charite University, Berlin, Germany at 1 site in Germany.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 14 Apr 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Germany. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Elisa A Stein, Dr. (+49 450 624354, elisa.stein@charite.de), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Improvement in Physical Function (PF) as measured by the Short Form 36 Health Survey Questionnaire (SF-36) (time frame: 8 weeks after first IA). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07529197, which also lists 6 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 14 Apr 2026.

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