TY - JOUR
T1 - Treatment of neuromyelitis optica with rituximab
T2 - Retrospective analysis of 25 patients
AU - Jacob, Anu
AU - Weinshenker, Brian G.
AU - Violich, Ivo
AU - McLinskey, Nancy
AU - Krupp, Lauren
AU - Fox, Robert J.
AU - Wingerchuk, Dean M.
AU - Boggild, Mike
AU - Constantinescu, Cris S.
AU - Miller, Aaron
AU - De Angelis, Tracy
AU - Matiello, Marcelo
AU - Cree, Bruce A.C.
PY - 2008/11
Y1 - 2008/11
N2 - Background: Neuromyelitis optica (NMO) is an uncommon, life-threatening inflammatory demyelinating disorder. Recently, much has become known about its immunopathogenesis. However, optimal treatments, with expected outcomes, have not been established. Objective: To evaluate the use and efficacy of rituximab for treating NMO. Design: Retrospective multicenter case series of NMO patients treated with rituximab. Setting: Seven tertiary medical centers in the United States and England. Patients: Twenty-five patients (including 2 children), 23 of whom experienced relapses despite use of other drugs before rituximab. Extended follow-up of 7 previously reported patients is included. Interventions: Infusions of rituximab at median intervals of 8 months. Main Outcome Measures: Annualized relapse rate and disability (expressed as Expanded Disability Status Scale score). Results: At a median follow-up of 19 months, the median annualized posttreatment relapse rate was lower than the pretreatment rate (0 [range 0-3.2] vs 1.7 [range, 0.5-5] relapses, P < .001). Disability improved or stabilized in 20 of 25 patients (80%, P = .02). Two patients died during the follow-up period, 1 owing to a brainstem relapse and 1 owing to suspected septicemia. Infections were reported in 20% of patients. Conclusions: In NMO, treatment with rituximab appears to reduce the frequency of attacks, with subsequent stabilization or improvement in disability.
AB - Background: Neuromyelitis optica (NMO) is an uncommon, life-threatening inflammatory demyelinating disorder. Recently, much has become known about its immunopathogenesis. However, optimal treatments, with expected outcomes, have not been established. Objective: To evaluate the use and efficacy of rituximab for treating NMO. Design: Retrospective multicenter case series of NMO patients treated with rituximab. Setting: Seven tertiary medical centers in the United States and England. Patients: Twenty-five patients (including 2 children), 23 of whom experienced relapses despite use of other drugs before rituximab. Extended follow-up of 7 previously reported patients is included. Interventions: Infusions of rituximab at median intervals of 8 months. Main Outcome Measures: Annualized relapse rate and disability (expressed as Expanded Disability Status Scale score). Results: At a median follow-up of 19 months, the median annualized posttreatment relapse rate was lower than the pretreatment rate (0 [range 0-3.2] vs 1.7 [range, 0.5-5] relapses, P < .001). Disability improved or stabilized in 20 of 25 patients (80%, P = .02). Two patients died during the follow-up period, 1 owing to a brainstem relapse and 1 owing to suspected septicemia. Infections were reported in 20% of patients. Conclusions: In NMO, treatment with rituximab appears to reduce the frequency of attacks, with subsequent stabilization or improvement in disability.
UR - http://www.scopus.com/inward/record.url?scp=55949127730&partnerID=8YFLogxK
U2 - 10.1001/archneur.65.11.noc80069
DO - 10.1001/archneur.65.11.noc80069
M3 - Article
C2 - 18779415
AN - SCOPUS:55949127730
SN - 0003-9942
VL - 65
SP - 1443
EP - 1448
JO - Archives of Neurology
JF - Archives of Neurology
IS - 11
ER -