The big lesson

The International ME/CFS Conference at Charité in Berlin (May 2026) drew more than 7,300 participants in person and online.¹ According to preliminary data, every randomised, placebo-controlled trial presented there missed its primary endpoint.²

That sounds bleak, but there’s an important pattern underneath. In trials of LDN, immunoadsorption and BC007, some individual patients responded well, and those responses were lost in the overall “no difference” result. Researchers are now selecting patients by biomarker, e.g. testing autoantibody treatments only in people who have those autoantibodies.

Conference recordings (with English slides and subtitles) are at events.mecfs-research.org.

Promising or positive

Result	What happened
Bezisterim (BioVie), Sept 2026 RCT Adjacent field³	203-patient Long COVID trial. Oral, crosses into the brain, thought to reduce inflammation. Missed significance in the overall group (though 21 of 22 measures leaned in its favour), but helped significantly in subgroups with high fatigue, brain fog and/or PEM (about 78% of those enrolled). The company describes these subgroups as pre-planned. These are the company’s own topline results, presented as a conference poster in October 2026, and haven’t been peer-reviewed yet; many outcomes were tested, so the subgroup findings need confirming. A Phase 3 trial is planned. The most relevant readout of 2026 for ME/CFS, because PEM-heavy patients responded.
Structured pacing (RECOVER-ENERGIZE, 300 people with Long COVID and PEM, Oct 2026) RCT Adjacent field⁴	Over 12 weeks, a structured pacing programme reduced how often and how badly people had PEM compared with usual care. The first randomised evidence for pacing in people with PEM. Participants knew which group they were in and the results are self-reported and not yet peer-reviewed. See Pacing.
Low-dose rapamycin (Simmaron) Open-label⁵	74% of 70 patients improved in fatigue, PEM and orthostatic symptoms. No placebo group. See Medications.
Hyperbaric oxygen (Charité) Observational⁶	Benefit with 40 sessions; the 20-session comparison presented at the conference showed less
Rovunaptabin (BC007) in autoantibody-positive patients RCT Adjacent field⁷	A 30-person placebo-controlled trial in Erlangen (published July 2025) that selected Long COVID patients by autoantibody improved fatigue and function
Fluvoxamine; a synbiotic RCT Adjacent field^8,9	Modest fatigue improvements in Long COVID trials (399 and 463 people)
RESETME pilot (daratumumab), Norway Open-label¹⁰	6 of 10 responded, some walking 10,000+ steps a day; 5 remained well at 12–24 months (and, per the researchers’ conference update, 2–3 years). A 66-person placebo-controlled trial is now under way (closed to new applicants).¹¹

Negative results

Trial	Result
Canadian LDN trial (160 people; post-COVID fatigue) RCT Adjacent field^12,2,13	No better than placebo on fatigue, pain, symptoms, daily steps or quality of life (full results October 2026, not yet peer-reviewed). More than 40% of the placebo group reportedly improved. Long COVID only: people who had ME/CFS before COVID were excluded, so it doesn’t answer whether LDN helps ME/CFS. See LDN.
Charité immunoadsorption (44 treated vs 21 sham) RCT^14,2	No significant difference in fatigue at 60 days. Criticised for not selecting autoantibody-positive patients; in a separate open-label series of 20 autoantibody-positive patients, 14 responded.¹⁵
PoCoVIT (methylprednisolone) RCT^16,2	Stopped early after five serious clotting events. No benefit.
Myoflame-19 (prednisolone + losartan, 279 patients) RCT Adjacent field¹⁷	No benefit
PreVitaCOV (low-dose prednisolone and/or B vitamins for 4 weeks, 323 people with Long COVID, Oct 2026) RCT Adjacent field¹⁸	Prednisolone eased symptoms slightly, but by less than the amount the researchers had set as a noticeable difference. B vitamins did nothing.
BC007 BLOC trial (2024, 119 unselected patients) RCT^19,20	No better than placebo. The company went insolvent; APTA Therapeutics has since acquired its assets and plans a new trial.²¹
Ivabradine (RECOVER-AUTONOMIC, 181 people with Long COVID POTS) RCT Adjacent field²²	Lowered heart rate on standing, but symptoms didn’t improve
AER002 antibody (Long COVID, 36 people, Oct 2026) RCT Adjacent field²³	No difference from placebo on physical health or any secondary outcome. A hint that some people may respond needs a new trial to test.
Paxlovid, temelimab, high-dose CoQ10 (Long COVID) RCT Adjacent field^24,25,26,27	No benefit. For Paxlovid this includes RECOVER-VITAL (959 people, Aug 2026), which tested courses of up to 25 days.
Charité multidisciplinary care and rehabilitation programme (182 people, published Sept 2026) Controlled²⁸	No difference in physical function at 12 months versus usual care. On the Bell disability scale, 42 of 94 (45%) got worse after rehabilitation and only 13 (14%) improved.

Key science findings of 2026

Brain waste clearance: Griffith University showed the brain’s glymphatic system is impaired in ME/CFS (July).
Muscles, not brain: a Stanford whole-body PET study found inflammation-type signals in muscle, not brain (May).
Blood flow without a racing heart: Brigham & Women’s found blood flow to the brain drops when upright even when heart rate is normal (January).
Sickness response: the Komaroff review set out how a normal “sickness” programme in the brain may fail to switch off (September).
No sign of “microclots” in Long COVID: a careful UK study of 117 people who were never in hospital found no clotting abnormality and no extra fibrin “microaggregates” compared with people who had recovered from COVID. The authors say blood thinners aren’t justified outside trials (October).²⁹
GPCR autoantibodies not linked to fatigue: in a German study of 206 people after COVID, levels of autoantibodies against 13 receptors were no different in people with post-COVID fatigue (October). The test measured binding, not whether the antibodies do anything.³⁰

More detail on The science.

What to watch next

Bezisterim Phase 3 planning
RESETME (daratumumab) placebo-controlled results¹¹
Griffith LDN trials in ME/CFS and Long COVID
REVERSE-LC (baricitinib) results, expected 2027
Peer-reviewed publication of the Canadian LDN trial (posted as a preprint in October 2026)
RECOVER-ENERGIZE exercise results, which test exercise advice separately for people with and without PEM
Australia’s new NHMRC ME/CFS clinical guidelines

References

International ME/CFS Conference 2026: over 7,300 participants News
ME/CFS Research Foundation, 2026
International ME/CFS conference roundup: setbacks and new hopes for therapeutic research News
Rücker M, The Sick Times, 2026. Coverage of the International ME/CFS Conference, Berlin, 7–8 May 2026
BioVie announces topline results from Phase 2 ADDRESS-LC trial of bezisterim in Long COVID RCT
BioVie Inc., 2026. n=203; no endpoint significant overall; significant in pre-specified high-fatigue, high-PEM and high-cognitive-impairment subgroups (about 78% of participants)
RECOVER-ENERGIZE Appendix B: Structured Pacing (NCT06404073), results RCT
NIH RECOVER Initiative, Duke University, ClinicalTrials.gov, 2026. Results posted 6 Oct 2026, not peer-reviewed: 300 people with Long COVID and PEM; structured pacing reduced PEM frequency (-0.46, 95% CI -0.65 to -0.27) and severity (-0.47, -0.65 to -0.30) on a 0-4 scale vs usual care at 12 weeks; unblinded
Low-dose rapamycin alleviates clinical symptoms of fatigue and PEM in ME/CFS patients via improvement of autophagy: a pilot study Open-label
Ruan BT et al. (Simmaron Research), Journal of Translational Medicine, 2025. 109 enrolled; 52 of 70 (74%) who reached day 30 were responders; 6 mg weekly; no placebo group
Hyperbaric oxygen therapy improves clinical symptoms and functional capacity and modulates thalamic connectivity in ME/CFS: a prospective cohort study Observational
Kim L et al. (Scheibenbogen C), Journal of Translational Medicine, 2026. 30 patients completed 40 sessions; the 20-session comparison was presented at the Berlin conference (May 2026)
Safety, tolerability and clinical effects of rovunaptabin (BC007) in post-COVID syndrome (reCOVer): a prospective, exploratory, placebo-controlled, double-blind, randomised phase IIa trial RCT
Hohberger B et al., EClinicalMedicine, 2025. n=30, autoantibody-selected; fatigue and function improved vs placebo
The effect of fluvoxamine and metformin for fatigue in patients with long COVID (REVIVE) RCT
Reis G et al. (Mills EJ), Annals of Internal Medicine, 2026. n=399; fluvoxamine modestly reduced fatigue; metformin did not
A synbiotic preparation (SIM01) for post-acute COVID-19 syndrome in Hong Kong (RECOVERY): a randomised, double-blind, placebo-controlled trial RCT
Lau RI et al., Lancet Infectious Diseases, 2024. n=463; fatigue improved more on the synbiotic
Plasma cell targeting with the anti-CD38 antibody daratumumab in ME/CFS: a clinical pilot study Open-label
Fluge Ø et al., Frontiers in Medicine, 2025. 10 patients; 6 improved; 5 sustained at 12–24 months
Plasma cell targeting using daratumumab in ME/CFS (EU CT 2024-520094-13-00) Registry
Helse Bergen, EU Clinical Trials Register, 2025. Randomised, double-blind, placebo-controlled; 66 participants
A Double Blind Randomized Trial of Low-dose Naltrexone for Post-COVID Fatigue Syndrome (NCT05430152) Registry
Nacul L, University of British Columbia, ClinicalTrials.gov, 2026. 160 enrolled; pre-existing ME/CFS excluded; primary outcome fatigue at 16 weeks
Low Dose Naltrexone for Post-COVID Fatigue Syndrome: A Randomized Controlled Trial RCT
Naik H, Nacul L et al., medRxiv (preprint), 2026. Full results of NCT05430152, posted 26 Oct 2026, not yet peer-reviewed: 160 people (81 LDN, 79 placebo), up to 4.5 mg/day for 16 weeks; no difference in fatigue (-0.76, 95% CI -4.18 to 2.67), pain, symptoms, daily steps or quality of life
Immunoadsorption in post-COVID ME/CFS (IA-PACS-CFS, NCT05710770) Registry
Charité – Universitätsmedizin Berlin, ClinicalTrials.gov, 2025. Sham-controlled, n=66; results presented at the Berlin conference, May 2026
Efficacy of immunoadsorption in post-COVID ME/CFS with autoantibodies: final results of a prospective observational study Open-label
Stein E et al. (Scheibenbogen C), Lancet Regional Health – Europe, 2025. 20 autoantibody-positive patients; 14 responded
PoCoVIT: methylprednisolone in post-COVID syndrome (NCT05986422) Registry
Charité – Universitätsmedizin Berlin, ClinicalTrials.gov, 2026. Terminated on data safety monitoring board advice; results presented May 2026
Losartan and prednisolone for post-COVID syndrome and cardiac inflammation (Myoflame-19) RCT
Puntmann VO et al., Nature Communications, 2026. n=279; no benefit
Low-dose prednisolone and B vitamins for post-COVID-19 syndrome in Germany: the PreVitaCOV randomised clinical trial RCT
Gágyor I, Klug A, Kaduszkiewicz H et al., eClinicalMedicine, 2026. 323 people, 28 days of treatment: prednisolone improved symptom score by 1.4 points (below the pre-set 3-point threshold for a meaningful change); B vitamins -0.1 (no effect)
Berlin Cures: BC 007 does not show superiority over placebo News
Altea Network, 2024
Berlin Cures' failed Long COVID clinical trial yields lessons on study design News
The Sick Times, 2025
APTA Therapeutics news room News
APTA Therapeutics, 2025. Announced acquisition of Berlin Cures' assets, July 2025
RECOVER-AUTONOMIC clinical trial results shared at 2026 ACC conference RCT
NIH RECOVER Initiative, 2026. Ivabradine vs placebo, n=181; heart rate on standing fell but symptoms did not improve
SARS-CoV-2-specific monoclonal antibody AER002 in Long COVID: an exploratory randomized phase 2a mechanistic trial RCT
Peluso MJ et al., Nature Communications, 2026. 36 people, randomised 2:1: one AER002 infusion did not beat placebo on physical health at day 90 or secondary outcomes
Nirmatrelvir-ritonavir and symptoms in adults with postacute sequelae of SARS-CoV-2 infection: the STOP-PASC randomized clinical trial RCT
Geng LN et al., JAMA Internal Medicine, 2024. n=155; no benefit
Nirmatrelvir–ritonavir targeting viral persistence in post-COVID-19 condition (long COVID) in the USA (RECOVER-VITAL): a randomised, double-blind, placebo-controlled, phase 2 trial RCT
Baden LR et al., Lancet Infectious Diseases, 2026. 959 adults: 15 or 25 days of Paxlovid gave no benefit over placebo
Temelimab in post-COVID condition: a randomised placebo-controlled trial RCT
Nehme M et al., Brain, Behavior, and Immunity, 2026. n=203; no benefit on fatigue
High-dose coenzyme Q10 therapy versus placebo in patients with post COVID-19 condition: a randomized, phase 2, crossover trial RCT
Hansen KS et al., Lancet Regional Health – Europe, 2023. n=121; 500 mg/day; no benefit
Evaluation of an integrated multidisciplinary care model for ME/CFS: a prospective, open-label, non-randomized controlled intervention study Controlled
Peters CK et al. (Scheibenbogen C, Wittke K), American Journal of Medicine, 2026. 182 participants; on the Bell disability scale 42 of 94 (45%) in the programme worsened and 13 (14%) improved
No evidence of hypercoagulability, altered fibrinolysis, or increased fibrin(ogen) microaggregates in never-hospitalized long COVID Observational
Fraser E, Ariëns R, Shapiro S et al., HemaSphere, 2026. 117 people with specialist-confirmed Long COVID vs 34 recovered controls: no clotting or fibrinolysis abnormality; microaggregates (measured in 55) no different; authors say antithrombotic therapy is not justified outside trials
Receptor-binding autoantibodies are not associated with post-COVID fatigue Observational
Achleitner M, Steenblock C et al., Brain, Behavior, & Immunity - Health, 2026. 206 people after COVID: autoantibodies binding 13 receptors (including GPCRs) didn't differ by fatigue status or severity; doesn't test whether the antibodies affect receptor function

2026 results