An open label study of the effects of rituximab in neuromyelitis optica

Cree, Bruce A.C.; Lamb, S. V.; Morgan, Katherine A.; Chen, A.; Waubant, Emmanuelle; Genain, Claude P.

doi:10.1212/01.wnl.0000159399.81861.d5

Cited by 595 publications

(376 citation statements)

References 8 publications

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“…Prednisone, azathioprine, and mycophenolate mofetil have all been effective in disease stabilization and relapse reduction in uncontrolled trials of NMO (41)(42)(43). The use of rituximab has been successful in a case series of patients with resistant disease (44). Notably, we have treated 1 patient (patient 5) with low-dose (500 mg) rituximab every 6 months, which has halted recurrence of myelitis.…”

Section: Discussionmentioning

confidence: 99%

Neuromyelitis optica spectrum disorder in patients with connective tissue disease and myelitis

Kolfenbach

Horner

Ferucci

et al. 2011

Arthritis Care & Research

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Section: Discussionmentioning

confidence: 99%

Neuromyelitis optica spectrum disorder in patients with connective tissue disease and myelitis

Kolfenbach

Horner

Ferucci

et al. 2011

Arthritis Care & Research

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“…The differentiation of NMO from multiple sclerosis is also of great importance. The fact that several studies [19][20][21] have shown that patients with NMO present a better response to early therapy with immunosuppressive drugs than to therapy with immunomodulating agents emphasizes the importance of an early and accurate diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Optical coherence tomography evaluation of retinal nerve fiber layer in longitudinally extensive transverse myelitis

Moura

Fernandes

Apóstolos‐Pereira

et al. 2011

Arq. Neuro-Psiquiatr.

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Objective: To compare optical coherence tomography (OCT) measurements on the retinal nerve fiber layer (RNFL) of healthy controls and patients with longitudinally extensive transverse myelitis (LETM) without previous optic neuritis. Method: Twenty-six eyes from 26 patients with LETM and 26 control eyes were subjected to automated perimetry and OCT for comparison of RNFL measurements. Results: The mean deviation values from perimetry were significantly lower in patients with LETM than in controls (p<0.0001). RNFL measurements in the nasal quadrant and in the 3-o'clock segment were significantly smaller in LETM eyes than in controls. (p=0.04 and p=0.006, respectively). No significantly differences in other RNFL measurements were found. Conclusion: Patients with LETM may present localized RNFL loss, particularly on the nasal side of the optic disc, associated with slight visual field defects, even in the absence of previous episodes of optic neuritis. These findings emphasize the fact that patients with LETM may experience attacks of subclinical optic nerve damage. Key words: tomography, optical coherence, transverse myelitis, neuromyelitis optica, multiple sclerosis.Avaliação da camada de fibras nervosas da retina na mielite transversal longitudi nalmente extensa usando tomografia de coerência óptica RESUMO Objetivo: Comparar as medidas da camada de fibras nervosas da retina (CFNR) usando a tomografia de coerência óptica (TCO) em indivíduos normais e pacientes com mielite transversal longitudinalmente extensa (MTLE) sem episódio prévio de neurite óptica. Método: Vinte e seis olhos de 26 pacientes com MTLE e 26 olhos normais foram submetidos à campimetria computadorizada e TCO para comparação das medidas da CFNR. Resultados: Valores do parâmetro desvio médio da campimetria computadorizada foram significativamente menores nos pacientes com MTLE do que nos controles (p<0,001). Medidas da CFNR no quadrante nasal e no segmento 3 horas foram significativamente menores nos olhos dos pacientes com MTLE do que nos olhos normais (p=0,04 e p=0,006, respectivamente). Não foi encontrada diferença significante nas outras medidas da CFNR avaliadas. Conclusão: Pacientes com MTLE podem apresentar perda localizada da CFNR, particularmente na região nasal do disco óptico, associada a defeitos discretos de campo visual, mesmo na ausência de episódio prévio de neurite óptica. Estes achados sugerem que pacientes com MTLE podem apresentar acometimento subclínico do nervo óptico. Palavras-chave: tomografia de coerência óptica, mielite transversa, neuromielite óptica, esclerose múltipla.

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“…Theoretically, the absence of attack-related inflammation could also release repair processes such as remyelination. Indeed, several studies investigating broad or selective immunosuppression reported an improvement of disability during the course of treatment [21,81,83,84,87,92,102,121,122].…”

Section: Discussionmentioning

confidence: 99%

“…It was the first specific immunosuppressant used for NMOSD. The pivotal open-label study from Cree et al [21] established B-cell depletion as a therapeutic principle for NMOSD; 6/8 patients were relapse-free after 1 year of treatment. Several clinical case series and retrospective analyses (including 10-55 patients each, treatment up to 8 years) have confirmed these findings and reported a reduction of ARR in 87-96 %, freedom from relapses in 44-72 %, and an improvement of disability in 80-100 % of patients [79,81,97,[99][100][101][102].…”

Section: Rituximab and Other B-cell-depleting Therapiesmentioning

confidence: 99%

“…Azathioprine (AZA) was among the first immunosuppressants reported to be effective for NMOSD [17]. Subsequently, the new diseasemodifying drugs approved for MS were given for NMOSD, with variable success [18][19][20], while more promising results came from B-cell depletion therapy [21]. The latter approach was a consequence of pathoanatomical and serological studies identifying humoral disease mechanisms, particularly complement activation and NMO-IgG, involved in the pathogenesis of NMOSD [22,23].…”

Section: Introductionmentioning

confidence: 99%

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Present and Future Therapies in Neuromyelitis Optica Spectrum Disorders

Kleiter

Gold

2016

Neurotherapeutics

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Neuromyelitis optica spectrum disorders (NMOSD) are important evolving entities, which have reached much attention in the recent years. NMOSD are characterized by inflammatory lesions in the optic nerves, spinal cord, and central parts of the brain, as well as an autoimmune process directed against aquaporin-4. As disability in NMOSD accumulates by inflammatory damage from attacks, both the treatment and prevention of attacks are decisive for the long-term outcome. NMOSD attacks are treated with highdose intravenous corticosteroids and apheresis therapies, in particular therapeutic plasma exchange. In cases of incomplete remission, escalation of attack treatment is recommended. Preventive therapy is immunosuppressive and should by commenced as early as possible. Apart from classical immunosuppressants such as azathioprine and mycophenolate mofetil, repurposed biologicals are increasingly used. B-cell depletion with rituximab and other agents, inhibition of the interleukin-6 receptor with tocilizumab, and blockade of complement-mediated damage by eculizumab all are promising therapeutic strategies evaluated in randomized controlled trials. In this review, we will discuss present and future immunotherapies for NMOSD and also consider combination of treatments, plasma, cellular and other therapies. Current advances in immunopathological knowledge are translated into innovative concepts and begin a new era of NMOSD therapy.

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An open label study of the effects of rituximab in neuromyelitis optica

Cited by 595 publications

References 8 publications

Neuromyelitis optica spectrum disorder in patients with connective tissue disease and myelitis

Neuromyelitis optica spectrum disorder in patients with connective tissue disease and myelitis

Optical coherence tomography evaluation of retinal nerve fiber layer in longitudinally extensive transverse myelitis

Present and Future Therapies in Neuromyelitis Optica Spectrum Disorders

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