Retrospective Observation of Low-Dose Rituximab Treatment in Chinese Patients With Neuromyelitis Optica Spectrum Disorders in a Real-World Setting

Xiao, Huiling; Zeng, Wenshuang; Li, Ling; Li, Lina; Cui, Yuzhen; Wang, Jie; Ye, Jinhao; Yang, Qi

doi:10.3389/fneur.2020.00642

Cited by 14 publications

(9 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…1), which was consistent with previous studies [16, 17]. However, previous studies on CD19 + B cells focused on the changes before and after RTX treatment, and they aimed to maintain the percentage of CD19 + B cells <1% [16, 17]. In our research, the current disease duration for acute NMOSD was 7 days (IQR = 10.5) and that for chronic NMOSD was 120 days (IQR = 157.5).…”

Section: Discussionsupporting

confidence: 93%

“…In our study, we found that the levels of peripheral blood CD19 + B cells were significantly higher in patients with acute NMOSD and remission NMOSD than in HCs (17.91 ± 8.7%, 13.08 ± 7.562%, and 12.48 ± 3.575%, respectively; p < 0.001) (Table 2; Fig. 1), which was consistent with previous studies [16, 17]. However, previous studies on CD19 + B cells focused on the changes before and after RTX treatment, and they aimed to maintain the percentage of CD19 + B cells <1% [16, 17].…”

Section: Discussionsupporting

confidence: 92%

See 1 more Smart Citation

Lymphocyte Subsets Are Associated with Disease Status in Neuromyelitis Optica Spectrum Disorders

Hong¹,

Liu

et al. 2021

Neuroimmunomodulation

View full text Add to dashboard Cite

Objective: At present, studies on lymphocytes are mostly conducted on CD19+ B cells and CD27+ B cells in neuromyelitis optica spectrum disorders (NMOSDs), but the exact changes in lymphocyte subsets (CD19+ B cells, CD3+ T cells, CD4+ Th cells, CD8+ Ts cells, the CD4+/CD8+ ratio, and NK [CD56+ CD16] cells) have rarely been studied. This study aimed to assess lymphocyte subset changes in patients with NMOSD. Methods: We performed a cross-sectional study of consecutive patients with acute NMOSD (n = 41), chronic NMOSD (n = 21), and healthy individuals (n = 44). Peripheral blood samples were obtained upon admission, and lymphocyte subsets were analyzed by flow cytometry. Levels of lymphocyte subsets among 3 groups were compared and its correlation with the length of spinal cord lesions was analyzed. Results: The levels of peripheral blood CD19+ B cells were significantly higher in patients with acute and chronic NMOSD than in healthy controls (HCs) (17.91 ± 8.7%, 13.08 ± 7.562%, and 12.48 ± 3.575%, respectively; p < 0.001) and were positively correlated with the length of spinal cord lesions in acute NMOSD (r = 0.433, p < 0.05). The peripheral blood CD4+/CD8+ ratio was significantly lower in patients with acute NMOSD and chronic NMOSD than in HCs (1.497 ± 0.6387, 1.33 ± 0.5574, and 1.753 ± 0.659, respectively; p < 0.05), and the levels of peripheral blood NK (CD56+ CD16) cells were significantly lower in patients with acute and chronic NMOSD than in HCs (13.6 ± 10.13, 11.11 ± 7.057, and 14.7 [interquartile range = 9.28], respectively; p < 0.01). Conclusions: The levels of certain subsets of peripheral blood lymphocytes are associated with disease status in NMOSD.

show abstract

Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 92%

Lymphocyte Subsets Are Associated with Disease Status in Neuromyelitis Optica Spectrum Disorders

Hong¹,

Liu

et al. 2021

Neuroimmunomodulation

View full text Add to dashboard Cite

show abstract

“…The capability of the immune system to resist viral infection is based on the humoral response mediated by B-cells. Some studies have shown B-cell inhibitors such as rituximab and azathioprine are often used as a long-term treatment method for the patients with NMOSD (11)(12)(13)(14), which could reduce concentrations of immunoglobulins G and M and increase the risk of COVID-19 infection (9,15). Therefore, patients who developed iatrogenic lymphopenia should be advised to maintain social distancing even in areas where lockdown has been removed or ameliorated (16).…”

Section: Introductionmentioning

confidence: 99%

COVID-19 Vaccination Attitudes With Neuromyelitis Optica Spectrum Disorders: Vaccine Hesitancy and Coping Style

Cao

et al. 2021

Front. Neurol.

View full text Add to dashboard Cite

Background: Vaccination is an important method by which to stop the spread of coronavirus disease 2019 (COVID-19) in a population. Patients with neuromyelitis optica spectrum disorders (NMOSD) have unstable immune function and receive immunosuppressive therapy frequently, so they are hardly to make a decision to receive vaccination. Our study investigated the vaccine hesitancy and coping styles in patients with NMOSD to analyze the relationship between vaccine hesitancy and coping styles, and elucidate the factors influencing vaccine hesitancy.Methods: A convenient sampling method was used to recruit participants. The Adult Vaccine Hesitancy Scale and Medical Coping Modes Questionnaire were used to measure the vaccine hesitancy and coping style of the participants. Pearson correlation, multiple stepwise, linear regression, and one-way analysis of variance were used to analyze the data.Results: A total of 262 NMOSD patients were investigated. The score of vaccine hesitancy in NMOSD patients is lower (21.13 ± 4.355) than 25 points which indicated the patient is not considered to have vaccine hesitancy. The score for vaccine hesitancy was negatively correlated with the confrontation and avoidance coping styles (r = −0.481 and r = 0.423). That adoption of the coping styles of confrontation and avoidance as well as the residence of the patient were predictors of vaccine hesitation in NMOSD patients (R2(adj) = 0.29, P < 0.001). In addition, the vaccine hesitancy scores of NMOSD patients residing in rural areas were significantly higher than those of patients living in urban areas (P < 0.01). Comparing with each level of education, the scores were not statistically significant in vaccine hesitancy and coping styles (P > 0.05).Conclusions: This study reveals that the NMOSD patients is not considered to have vaccine hesitancy, Patients who tend to adopt confrontation and avoidance coping styles have less vaccine hesitancy. Health authorities and medical specialist teams should strengthen effective vaccination information for patients with NMOSD, such as expert consensus or guidelines through various media to help them with decision-making. The significance of vaccination, the safety and side effects of COVID-19 vaccination and predicting of epidemiological trends of COVID-19 should be emphasized. More attention should be paid to NMOSD patients who living in rural areas.

show abstract

“…Furthermore, previous reports have shown that patients with autoimmune diseases, especially in the Chinese cohort, including anti-NF155 autoimmune nodopathies, MG, NMOSD, and Isaacs syndrome, responded very well to the low-dose rituximab regimen (10,(46)(47)(48)(49). This low-dose regimen could also lead to improvement of clinical manifestations, such as manual muscle testing and diseaserelated scales, decrease in antibody titers, and reduction of average steroid dosage by B cell elimination and subsequent B cell repopulation.…”

Section: Discussionmentioning

confidence: 92%

Effect of low-dose rituximab treatment on autoimmune nodopathy with anti-contactin 1 antibody

Hou

Zhang²,

Yu³

et al. 2022

Front. Immunol.

View full text Add to dashboard Cite

BackgroundAutoimmune nodopathy with anti-contactin-1 (CNTN1) responds well to rituximab instead of traditional therapies. Although a low-dose rituximab regimen was administered to patients with other autoimmune diseases, such as myasthenia gravis and neuromyelitis optica spectrum disorders, and satisfactory outcomes were obtained, this low-dose rituximab regimen has not been trialed in anti-CNTN1-positive patients.MethodsAnti–CNTN1 nodopathy patients were enrolled in this prospective, open-label, self-controlled pilot study. A cell-based assay was used to detect anti-CNTN1 antibodies and their subclasses in both serum and cerebrospinal fluid. Clinical features were evaluated at baseline, 2 days, 14 days, and 6 months after single low-dose rituximab treatment (600 mg). The titers of the subclasses of anti-CNTN1 antibody and peripheral B cells were also evaluated at baseline, 2 days, and 6 months after the rituximab regimen.ResultsTwo patients with anti–CNTN1 antibodies were enrolled. Both patients had neurological symptoms including muscle weakness, tremor, sensory ataxia, numbness and mild nephrotic symptoms. In the field of neurological symptoms, sensory ataxia markedly improved, and the titer of anti-CNTN1 antibody as well as CD19+ B cells decreased only two days following low-dose rituximab treatment. Other neurological symptoms improved within two weeks of rituximab treatment. At the 6-month follow-up, all neurological symptoms steadily improved with steroid reduction, and both the anti-CNTN1 antibody titer and CD19+ B cells steadily decreased. No adverse events were observed after this single low-dose rituximab treatment.ConclusionsWe confirmed the clinical efficacy of low-dose rituximab by B cell depletion in autoimmune nodopathy with anti-CNTN1 antibody. This rapid and long-lasting response suggests that low-dose rituximab is a promising option for anti-CNTN1 nodopathy.

show abstract

Retrospective Observation of Low-Dose Rituximab Treatment in Chinese Patients With Neuromyelitis Optica Spectrum Disorders in a Real-World Setting

Cited by 14 publications

References 28 publications

Lymphocyte Subsets Are Associated with Disease Status in Neuromyelitis Optica Spectrum Disorders

Lymphocyte Subsets Are Associated with Disease Status in Neuromyelitis Optica Spectrum Disorders

COVID-19 Vaccination Attitudes With Neuromyelitis Optica Spectrum Disorders: Vaccine Hesitancy and Coping Style

Effect of low-dose rituximab treatment on autoimmune nodopathy with anti-contactin 1 antibody

Contact Info

Product

Resources

About