§ The Countess of Marasked Her Majesty's Government:
How many randomised clinical trials have demonstrated the effectiveness of cognitive behavioural therapy, graded exercise therapy and pacing as methods of treating patients suffering chronic fatigue syndrome or myalgic encephalomyelitis as opposed to patients 140WA suffering from chronic fatigue as a result of other causes; when the trials were conducted; and by whom; and [HL1971]
Upon what grounds patients suffering from fibromyalgia syndrome are included by the Medical Research Council in the entry criteria for the pacing. graded activity and cognitive behaviour therapy trials. [HL1974]
§ Lord WarnerThe only ground for participation by patients with fibromyalgia in the PACE (Pacing, Activity and Cognitive behaviour therapy: a randomised Evaluation) trial being funded by the Medical Research Council is that they meet the criteria for chronic fatigue syndrome (CFS), as many such patients do.
Of the trials already published, none offers the definitive answers about best treatment for CFS and myalgic encephalomyelitis (ME) in the way that the PACE trial will. PACE will be the first large-scale trial to assess all the standard available treatments including pacing, a popular treatment choice with patients for which no scientific evaluation exists.
Two independent systematic reviews of randomised controlled trials (RCTs) of the management of CFS and ME have concluded that rehabilitative cognitive behaviour therapy (CBT) and graded exercise therapy (GET) were the most promising treatments for CFS in secondary care. The reviews examined:
- four RCTs of CBT, three of which demonstrated better efficacy of CBT compared to usual medical care of a control treatment;
- three RCTs of GET, all of which showed some evidence of efficacy more than control treatments.
Details of the RCTs are included in the reviews, which are published as:
- Price JR, Couper J. Cognitive behaviour therapy for chronic fatigue syndrome in adults (Cochrane Review). In: The Cochrane Library, Issue 1,2004.
- Whiting P, et al. Intervention for the treatment and management of chronic fatigue syndrome. JAMA 2001; 286:1360–8.