Title :

Treatment of neuromyelitis optica with rituximab: a 2-year prospective multicenter study.

Author(s) :

Cabre, Philippe [Auteur]
Mejdoubi, M [Auteur]
Jeannin, S [Auteur]
Merle, H [Auteur]
Plumelle, Y [Auteur]
Cavillon, G [Auteur]
Smadja, D [Auteur]
Marignier, Romain [Auteur]
Vermersch, Patrick [Auteur]
Lille Inflammation Research International Center (LIRIC) - U995

Journal title :

Journal of Neurology

Abbreviated title :

J. Neurol.

Volume number :

265

Pages :

917–925

Publication date :

2018-04

ISSN :

1432-1459

Keyword(s) :

Rituximab
Neuromyelitis optica
Magnetic resonance imaging
Treatment

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Objective Neuromyelitis optica (NMO) is a very severe autoimmune disorder of the central nervous system. It affects young subjects and has a poor prognosis both on a functional and vital level. Therefore, it is imperative ...
Show more >Objective Neuromyelitis optica (NMO) is a very severe autoimmune disorder of the central nervous system. It affects young subjects and has a poor prognosis both on a functional and vital level. Therefore, it is imperative to reduce the frequency of relapses. The purpose of this study was to evaluate the clinical and neuroradiological effectiveness of rituximab (RTX) on active forms of NMO. Methods We conducted a 2-year open prospective multicenter study that included 32 patients treated with RTX at a dose of 375 mg/m2/week for 1 month. When the number of circulating CD19+ B cells reached 1%, a maintenance therapy was started, consisting of two infusions of 1 g of RTX, administered at a 15-day interval. The primary objective was to reduce the annual relapse rate (ARR), in comparison to that observed in the 2 years before treatment onset. Results Rituximab administration reduced the ARR from 1.34 to 0.56 (p = 0.0005). The average Expanded Disability Status Scale (EDSS) score significantly improved by 1.1 point, from 5.9 (2–9) to 4.8 (0–9) after 2 years (p = 0.03). Anti-aquaporin-4 antibodies’ level predicted treatment failure (p = 0.03). Frequency of Gad+ lesions in spinal cord decreased from 23.3 to 14.2%. RTX treatment did not prevent the death of three patients (treatment failure in two patients and acute myeloid leukemia in a patient previously treated with mitoxantrone). Conclusion Rituximab is clinically effective in active forms of NMO, although few patients are resistant to the treatment.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Inserm
Université de Lille
CHU Lille

Collections :

• Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286

Research team(s) :

Immunity, inflammation and fibrsis in auto and allo-reactivity

Submission date :

2019-03-01T14:46:27Z
2024-03-13T14:09:14Z