Around 10-20% of people who contract Lyme disease, the most common tickborne disease in the U.S., develop persistent, often debilitating symptoms such as chronic pain, fatigue, and cognitive dysfunction. Lyme infection-associated chronic illnesses (IACI) share symptoms common to other IACI such as Long COVID and myalgic encephalomyelitis/chronic fatigue syndrome. Despite the chronic impact on the quality of life for many people, there are currently no validated interventions to treat Lyme IACI.

In response to this unmet need, the Steven & Alexandra Cohen Foundation asked the National Academies to convene a committee of experts to assess the evidence for disease mechanisms, diagnoses, and treatments of Lyme IACI and illuminate a pathway for the development of new treatments. The resulting report, Charting a Path Toward New Treatments for Lyme Infection-Associated Chronic Illnesses, makes recommendations around developing treatments that improve function and quality of life based on currently available evidence, while continuing research to identify root causes and mechanisms of the disease.

Contents

• The National Academies of SCIENCES • ENGINEERING • MEDICINE
• COMMITTEE ON THE EVIDENCE BASE FOR LYME INFECTION-ASSOCIATED CHRONIC ILLNESSES TREATMENT
• Reviewers
• Acknowledgments
• Preface
• Acronyms and Abbreviations
• Glossary
• Summary
  • PERSON-CENTERED, SYMPTOM-BASED TREATMENT DEVELOPMENT
  • SHIFTING THE FOCUS: RIGOROUS CLINICAL TRIALS THAT TARGET SYMPTOMS
  • BROADENING THE EVIDENCE BASE: COLLABORATION ACROSS SIMILAR CONDITIONS
  • TIME FOR ACTION
• 1. Introduction
  • STUDY CONTEXT AND CHARGE
  • BACKGROUND
  • COMMITTEE APPROACH
  • REFERENCES
• 2. State of the Evidence
  • OPERATIONAL SCOPE FOR LITERATURE REVIEW ON LYME IACI RESEARCH
  • EPIDEMIOLOGY OF LYME IACI
  • A SCOPING REVIEW OF THE LITERATURE
  • EVIDENCE ON THE TREATMENT OF LYME IACI
  • EVIDENCE ON THE MECHANISMS OF LYME IACI
  • EVIDENCE ON THE DIAGNOSIS OF LYME IACI
  • KEY QUESTIONS FOR FUTURE RESEARCH
  • REFERENCES
• 3. Building on Research from Other Infection-Associated Chronic Illnesses
  • Surveying Potential Treatments with Focus on ME/CFS and Long COVID
  • CLINICAL EVIDENCE ON SYMPTOM-BASED APPROACHES TO TREATMENTS FOR IACI
  • OPPORTUNITIES FOR TRANSLATING PROMISING APPROACHES TO LYME IACI
  • LESSONS LEARNED
  • REFERENCES
• 4. Innovative Approaches to Accelerating Lyme IACI Research
  • A COMMON FRAMEWORK TO PRIORITIZE LYME IACI RESEARCH
  • RESEARCH INFRASTRUCTURE
  • DATA INTERPRETATION
  • CONSIDERATIONS FOR IMPLEMENTATION
  • REFERENCES
• 5. Recommendations
  • RESEARCH INTO NEW TREATMENTS THAT ALLEVIATE SYMPTOMS
  • STANDARDIZED RESEARCH DEFINITIONS AND METRICS
  • IMPROVED ACCESS TO BIOBANKS AND REGISTRIES
  • COORDINATED RESEARCH FUNDING AND COLLABORATION EFFORTS
  • COLLABORATION ACROSS IACI RESEARCH
  • CLOSING THOUGHTS
  • REFERENCES
• Appendix A. Committee Meeting Agendas
• Appendix B. Committee Member and Staff Biographies
• Appendix C. Methodology of Literature Review

Suggested citation:

National Academies of Sciences, Engineering, and Medicine. 2025. Charting a path toward new treatments for Lyme infection-associated chronic illnesses. Washington, DC: National Academies Press. https://doi.org/10.17226/28578.

Digital Object Identifier: https://doi.org/10.17226/28578

Library of Congress Control Number: 2025938379

This publication is available from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242; http://www.nap.edu.

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