Evaluación del uso de rituximab en la neuromielitis óptica

Fernández-Megía, María José; Casanova-Estruch, B; Pérez‐Miralles, Francisco; Ruiz-Ramos, Jesús; Alcalá-Vicente, Carmen; Poveda‐Andrés, José Luis

doi:10.1016/j.nrl.2014.09.001

Cited by 12 publications

(3 citation statements)

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“…[28] In the study by Fernández-Megía et al ., mean EDSS decreased from 4 to 3.25 after RTX therapy including three stable and three improved scores out of six patients. [29] Kim et al . conducted a retrospective review of 100 patients to evaluate the treatment outcomes of RTX in NMO patients.…”

Section: Effect Of Rituximab On Patient's Expanded Disability Status mentioning

confidence: 99%

“…As an example in a trial performed by Fernández-Megía et al ., two patients presented some types of infusion-related adverse effect after the first dose of rituximab that was resolved with administration of 80 mg methylprednisolone and an antihistamine. [29] In another study that was performed by Radaelli et al ., serious infectious status due to rituximab therapy led to death. This study also pointed to mild hematological adverse events.…”

Section: Safety Of Rituximabmentioning

confidence: 99%

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Efficacy and safety of rituximab in neuromyelitis optica: Review of evidence

et al. 2017

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Neuromyelitis optica (NMO) is an autoimmune inflammatory disease of the central nervous system with preferential involvement in the optic nerve and spinal cord with a widespread spectrum of clinical features; multiple therapeutic agents have been used with different results. Recent evidence points to B-cell-mediated humoral immunity in the pathogenesis of NMO. Rituximab targets the CD20 antigen on B-cells. Treatment leads to profound B-cell depletion, principally over an antibody-dependent cell cytotoxicity mechanism. The aim of our study was to review clinical trials to elucidate the impact of rituximab on the relapse rate, Expanded Disability Status Scale (EDSS), and progression of disability in NMO. We performed a comprehensive review of all studies that evaluated clinical and paraclinical effects of rituximab on NMO. MEDLINE-PubMed, Web of Sciences, EMBASE, and Cochrane databases up to June 2016 included in our searches. In addition, reference lists from articles identified by search as well as a key review article to identify additional articles included in the study. Rituximab targets the CD20 antigen on B-cells and decreases attack frequency and severity in patients with NMO; however, it does not remove attacks, even when modifying treatment to achieve B-cell depletion. Most of the investigations revealed that EDSS significantly in all patients with rituximab treatment will be decreased after treatment with rituximab. No new or enlarged lesions or pathological gadolinium enhancement was observed in serial brain and spinal cord magnetic resonance imaging, except for those observed concomitantly with clinical relapses and the median length of spinal cord lesions was significantly reduced after therapy. Rituximab targets the CD20 antigen and decreases attack frequency and severity in patients with NMO.

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Section: Effect Of Rituximab On Patient's Expanded Disability Status mentioning

confidence: 99%

Section: Safety Of Rituximabmentioning

confidence: 99%

Efficacy and safety of rituximab in neuromyelitis optica: Review of evidence

et al. 2017

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“…After treatment, there is a predominance of protective regulatory B lymphocytes over pathogenic memory B lymphocytes, which are predominant prior to treatment. The most commonly reported adverse effects of rituximab therapy include infusion-related effects [ 4 ], urogenital infection, and varicella zoster virus reactivation [ 5 ], although some deaths have been reported secondary to extensive myelitis [ 6 ] and urosepsis [ 5 ]. Another rare but serious complication is rituximab-associated lung injury (RALI).…”

Section: Discussionmentioning

confidence: 99%

Secondary Hypogammaglobulinemia After Rituximab for Neuromyelitis Optica: A Case Report

Farhat

Dara

Duberstein

et al. 2018

Drug Saf - Case Rep

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A 17-year-old male with history of neuromyelitis optica and seizures presented to the pulmonology clinic for evaluation of recurrent pneumonias. He had received rituximab for the past 6 years. Over the past 2 years, he experienced four episodes of pneumonia. In between these episodes, he would improve briefly but continued to have daily cough that was productive with yellow phlegm. He also had recurrent rhinitis and sinusitis despite multiple antibiotic courses. Review of chest X-rays revealed localized right middle lobe and right lower lobe infiltrates. An extensive workup was performed, including computed tomography (CT) of the chest and bronchoscopy to rule out congenital lesions of the right lung and foreign body aspiration. Chest CT showed right lower lobe bronchiectasis. Flexible bronchoscopy with bronchoalveolar lavage showed normal anatomy with thick mucus secretions in the right lower lobe. Immunologic evaluation was performed and revealed low levels of immunoglobulin (Ig)-G, IgM, and IgA, which had declined since initiation of rituximab. Lymphocyte subset testing was remarkable for low cluster of differentiation (CD)-19. He was referred to allergy and immunology and was initiated on immunoglobulin-replacement therapy (IGRT) for acquired hypogammaglobulinemia secondary to rituximab. There was marked clinical improvement after initiation of IGRT.

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