Real-world data from the largest U.S. Lyme disease registry, MyLymeData, shows current clinical trials for persistent Lyme disease (PLD) systematically exclude most patients who are clinically diagnosed with the condition.

A groundbreaking analysis of over 4,000 patients reveals that 9 out of 10 people with PLD are barred from participating in clinical trials, primarily due to outdated eligibility criteria.

The impact is severe. Nearly two million Americans live with PLD, with 72% reporting poor or fair health—compared to just 13% of the general population. These patients also face elevated suicide risk.

“Excluding the very patients we need to study”

“The way researchers currently design clinical trials excludes 90% of patients, resulting in small studies that take too long, cost too much, and don’t apply to most patients,” states Lorraine Johnson, CEO of LymeDisease.org and principal investigator of MyLymeData. “Overly stringent criteria exclude the very patients we need to study, leaving clinicians without relevant findings for their practice.”

Key findings:

• Most exclusions stem from co-existing tick-borne infections or previous misdiagnoses of chronic fatigue syndrome or fibromyalgia

• Relaxing unnecessary restrictions could increase patient enrollment from 10% to 64%

• This is the first real-world data analysis of PLD trial criteria, despite FDA’s 2018 recommendation to broaden eligibility across all medical research

The study, “Optimizing Exclusion Criteria for Clinical Trials of Persistent Lyme Disease Using Real-World Data,” was funded by Bay Area Lyme Foundation.

“Clinical trials are crucial to finding effective treatments,” emphasizes co-author Dr. Raphael Stricker, “but they must include the PLD patients that clinicians treat every day. Otherwise, the trials are out of touch with the real world.”

The study coauthors are Lorraine Johnson of LymeDisease.org, Los Angeles, CA; Mira Shapiro of Analytic Designers LLC, Bethesda, MD; Deanna Needell of the University of California at Los Angeles, CA; and Raphael Stricker, of Union Square Medical Associates, San Francisco, CA.

About LymeDisease.org

LymeDisease.org is a national nonprofit dedicated to advocacy, education, and research related to Lyme disease. As the organization behind MyLymeData, the largest patient-led Lyme disease registry in the United States, we work to accelerate scientific discovery and improve patient care.