Statements on the PACE trials

The two biggest medical trials funded by the MRC atm are the FINE and PACE trials.

According to the website the PACE trial is 'the first 'large-scale trial in the world to test and compare the effectiveness of four of the main treatments currently available for people suffering from chronic fatigue syndrome (CFS), also known as myalgic encephalomyelitis (ME)'

These are, also quoted from their website;

'

• Standardised specialist medical care. This is the most common treatment for CFS/ME. Specialist doctors can give an explanation of why participants are ill and general advice about managing the illness. They may also prescribe medicines to help with troublesome symptoms such as insomnia and pain, or advise GPs on what medicine is appropriate. If a participant is randomised to this treatment alone, they are encouraged to use specific self-help management that make most sense to them.   .
• Adaptive pacing therapy. This therapy is about carefully matching activity levels to the amount of energy available. Therapists work with participants in this treatment group to help monitor activity and symptoms, aiming to improve quality of life and create the best conditions for a natural recovery.
• Cognitive behaviour therapy. This therapy is about examining how thoughts, behaviour and CFS/ME symptoms interact with each other. Between therapy sessions, participants in this treatment group are encouraged to try out new ways of coping with their illness.
• Graded exercise therapy. This is about gradually increasing physical activity to improve fitness and get the body used to activity again. A therapist helps participants in this treatment group to work out a basic activity routine and slowly build up the amount of exercise as fitness increases.

I'm dissapointed they're not doing proper biomedical research so they could develop a drug or something. Its very difficult, if not impossible to manage your symptoms using these therapies

Another quote I don't like;

' No responsibility is accepted by the authors for the application of treatments described in these manuals outside of the PACE trial.'

The apparent results;

“We affirm that cognitive behaviour therapy and graded exercise therapy are moderately effective outpatient treatments for chronic fatigue syndrome when added to specialist medical care, as compared with adaptive pacing therapy or specialist medical care alone. Findings from PACE also allow the following interpretations: adaptive pacing therapy added to specialist medical care is no more effective than specialist medical care alone; our findings apply to patients with differently defined chronic fatigue syndrome and myalgic encephalomyelitis (ME) whose main symptom is fatigue; and all four treatments tested are safe.”

In a linked *Comment*, Dr Gijs Bleijenberg, and Dr Hans Knoop, Expert Centre for Chronic Fatigue, Radboud University NijmegenMedical Centre, Netherlands, say: “The central role of cognition in relation to fatigue might explain why graded exercise therapy is effectiveand adaptive pacing therapy is not.” They note that /in adaptive//pacing patients learn to focus on the fatigue in order to stop “in time”, which does not seem to help, while in graded exercise patients learn that they are able to do more than they thought possible

Statement on it from Invest in ME, a support group;

The PACE Trials have recently been published and demonstrate clearly what is wrong with the present way that vested interests have manipulated the establishment view about myalgic encephalomyelitis (ME/CFS) and forced tens of thousands of patients and their families to live in a continual state where no proper research is sanctioned, good science is denied and where pointless and biased studies are funded by a system which denies human rights.

Simple facts:

The Pace Trials cost nearly £5 million pounds of tax payers' money.

Patients were opposed to the trials right from the start due to patient selection criteria - save from two unrepresentative organisations who have taken money from the government in order to accept their policies toward ME.

ME is a distinct neurological illness and has been classified as such since the 1969 by the WHO in ICD10-G93.3. Fatigue Syndrome has its own classification in F48.

It is in none of the patient groups' interest in mixing these patient cohorts and trying to find a one size fits all management technique.

The purpose of any medical research should be the benefit of the patients and the PACE trials do not benefit ME patients but rather known vested interests who control what the media publish and what the Medical Research Council fund in relation to ME/CFS.

In recent years Invest in ME has been contacted more and more by patients or their carers asking for advice as the NICE guidelines recommendation of using CBT and GET has been forced upon them and patients have been bullied into activities beyond their limits.

This has led to some severe consequences such as suicide attempts but parents of children in such cases are often afraid of complaining due to fear of their children being taken into care.

We fear this is going to get worse now after these PACE trial results are being taken at face value.

How ironic it is that the Department of Health and the UK National Blood Services permanently prohibit people with ME/CFS from donating blood - their reasoning being that ME/CFS is a relapsing condition and this was to protect the health of patients. Yet now the message to the healthcare professionals from the PACE trials is that graded excercise and cognitive behaviour therapy are helpful - thus forcing vulnerable and physically ill people to risk further damage to their health.

By any measure the PACE trials are flawed and are not the result of proper research. Using diagnostic criteria which do not define patients with ME/CFS and which exclude people with neurological disorders means that patients participating in these trials were of a heterogeneous variety - thus making the results completely irrelevant.

This nullifies all of this study.

The PACE trials are designed, created and performed by those who view ME/CFS as a consequence of wrong illness beliefs or deconditioning.

The PACE trials are bogus science and have no relevance in the treatment of people suffering from myalgic encephalomyelitis.

All I want is to get better, is that so much to ask?