Rituximab in chronic inflammatory demyelinating polyradiculoneuropathy with associated diseases

Roux, Thomas Le; Debs, Rabab; Maisonobe, Thierry; Lenglet, Timothée; Delorme, Cécile; Louapre, Céline; Leblond, Véronique

doi:10.1111/jns.12287

Cited by 42 publications

(28 citation statements)

References 20 publications

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“…Three patients had antineurofascin155 antibodies. The positive results of the Roux et al study cannot be extended to patients with idiopathic CIDP because the response to treatment in patients with CIDP with associated autoimmune or oncologic disease may be different. Because of several case reports and small case series that have provided evidence of the efficacy of rituximab in CIDP, the role of rituximab in the treatment of patients with idiopathic CIDP must be investigated.…”

Section: Discussionmentioning

confidence: 95%

“…In general, immune‐mediated disorders related to the IgG4 subtype of Ig have a tendency to respond to B‐cell‐depleting therapies. There are several anecdotal reports and small case series that suggest that some patients with CIDP may respond to rituximab . There is a suggestion that a subset of patients with CIDP with antibodies to nodal antigens such as neurofascin, contactin‐associated protein 1, and contactin respond most favorably .…”

Section: Discussionmentioning

confidence: 99%

“…Also, some patients with IgM gammopathy‐related neuropathy respond to treatment with rituximab . In the largest CIDP rituximab study conducted to date, Roux et al included 28 patients, but all patients had associated disorders that required rituximab treatment; these included patients with monoclonal gammopathy of unknown significance, B‐cell lymphoma, lupus, anti‐Ro/SSA and anti‐La/SSB antibodies, and rheumatoid arthritis. Three patients had antineurofascin155 antibodies.…”

Section: Discussionmentioning

confidence: 99%

“…In these situations, several treatment strategies, including rituximab, cyclophosphamide, and bone marrow transplantation may be considered, although the potential risks must be weighed against uncertain benefits for each of these strategies . There has been increasing interest in the use of rituximab to treat patients with intractable CIDP because of its ease of use and the suggestion of its efficacy in patients with nodal antibodies . To determine the efficacy of rituximab in treating intractable CIDP, we retrospectively analyzed outcomes for 11 patients with CIDP treated with rituximab from three different academic medical centers in the United States.…”

Section: Introductionmentioning

confidence: 99%

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Rituximab in refractory chronic inflammatory demyelinating polyneuropathy

et al. 2020

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Introduction: Chronic inflammatory demyelinating polyneuropathy (CIDP) is a disorder in which early effective treatment is important to minimize disability from axonal degeneration. It has been suggested that some patients with CIDP may benefit from rituximab therapy, but there is no definitive evidence for this. Methods: Baseline and post-rituximab-therapy neuromuscular Medical Research Council (MRC) sum scores, Inflammatory Neuropathy Cause and Treatment (INCAT) disability score, and functional status were assessed in 11 patients with refactory CIDP.Results: The MRC sum score, INCAT disability score, and functional status improved in all patients after rituximab therapy. Discussion:Our study provides evidence of the efficacy of rituximab therapy in at least some patients with CIDP. A placebo-controlled study to assess the effectiveness of rituximab therapy in CIDP with and without nodal antibodies is required to identify disease markers that predict responsiveness. K E Y W O R D S

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Rituximab in refractory chronic inflammatory demyelinating polyneuropathy

et al. 2020

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“…Rituximab is a chimeric anti‐CD20 monoclonal antibody initially mainly used by oncologists and rheumatologists for blood malignancies and certain forms of vasculitis in rheumatoid arthritis . RTX has also shown effects in neurological conditions such as myasthenia gravis and chronic inflammatory demyelinating neuropathy . Favorable properties of RTX are the strong efficacy data shown by two randomized studies, its acceptable safety profile, and the 6‐ to 12‐month treatment interval.…”

Section: Introductionmentioning

confidence: 99%

Rituximab in multiple sclerosis at general hospital level

2020

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| 491 wileyonlinelibrary.com/journal/ane | INTRODUC TI ONSeveral new disease-modifying therapies (DMTs) have emerged during the last decades for people with multiple sclerosis (MS), which brings both opportunities and challenges to daily praxis. There are multiple issues other than drug efficacy that must be addressed before deciding on treatment modality. Besides disease-related inflammatory aggressiveness and subjects' susceptibility to drug-specific adverse events, subjects' preferences, and cost-benefit aspects also have to be taken into consideration. As a consequence, a gap is developing between the national guidelines authorized by the Swedish Medical Products Agency 1 and real-life treatment selection.Sweden stands out with its high use of off-label rituximab (RTX), representing approximately 40% of all ongoing DMTs in MS care. 2 Furthermore, a Swedish study that included subjects with MS from three tertiary academic hospitals showed that as many as 53.3% of all subjects were given RTX as the primary DMT for MS. 3 The published data extracted from the Swedish MS registry show increased Objectives: The use of rituximab (RTX) in multiple sclerosis (MS) is a rapidly increasing choice of disease-modifying therapy. Efficacy outside specialized university hospital-based care is not yet systematically investigated. Our aim was to evaluate off-label RTX treatment for MS at a general hospital in Sweden. Materials and Methods: Subjects with definite MS with at least one rituximab infusion were eligible for inclusion in this retrospective, observational study. Effect was evaluated by monitoring clinical disability, annual relapse rate, new lesions on MRI, and safety by the incidence and severity of adverse events. Results: Among the 83 included subjects, 15 had clinical worsening of disease during the median 23.5 (1-76) months of follow-up after RTX initiation: 7/66 with relapsing-remitting multiple sclerosis (RRMS) and 8/17 with progressive subtypes (PMS).Cumulative survival without worsening was 86% in RRMS and 30% in PMS. The annual relapse rate before RTX vs follow-up dropped from 0.38 to 0.05 (P < .00001).Subjects with new enhancing lesions on MRI during the first year before RTX initiation vs the year after dropped from 0.94 to 0.024 (P < .00001) and was only seen in RRMS (1.05-0.31, P = .00003). Adverse events were mainly mild. Thirty-six out of 53 non-infusion-related adverse events were infections, of which four were serious, including a case of pneumonia with concomitant late-onset neutropenia. Conclusions:Rituximab was as effective and safe when given at a general hospital outpatient clinic compared with results from previous university hospital-based studies. Vigilance is required concerning severe adverse events. K E Y W O R D Smultiple sclerosis, rituximab, safety management

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Efficacy and safety of combined low‐dose rituximab regimen for chronic inflammatory demyelinating polyradiculoneuropathy

Du,

Yan,

et al. 2024

Ann Clin Transl Neurol

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ObjectiveTo determine the efficacy and safety of combined low‐dose rituximab with conventional therapy for chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) treatment.MethodsTotal 73 patients with CIDP were enrolled for the retrospective cohort study, and divided into conventional first‐line therapy cohort (n = 40) and combined low‐dose rituximab (100 mg per infusion) cohort (n = 33). The outcome measures include scores of I‐RODS, mRS, INCAT, ONLS, TSS, and COMPASS 31 scale at baseline and regular four visits (4, 16, 28, and 52 weeks), as well as proportion of favorable response and outcome, corticosteroids dosage, and deterioration occurrence during follow‐up.ResultsCompared to conventional therapy cohort, combined rituximab cohort presented better improvements and higher proportion of favorable response in scales assessments at each visit, as well as significantly reduced corticosteroids dosage and deterioration occurrence during the follow‐up. Analyses of subgroups showed better improvements in both typical CIDP and CIDP variants in combined rituximab cohort than those in conventional therapy cohort, but had no differences between each other. Early initiating combined rituximab regimen (<10 weeks) showed better improvements than delayed initiation (≥10 weeks) at the first three visits within 28 weeks, while had no difference in favorable prognoses at the last visit of 52 weeks after once reinfusion. No rituximab correlated serious adverse events were reported in our patients.InterpretationOur simplified regimen of combined low‐dose rituximab has been firstly demonstrated for the better efficacy and safety than conventional therapy in CIDP treatment.

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Rituximab in chronic inflammatory demyelinating polyradiculoneuropathy with associated diseases

Cited by 42 publications

References 20 publications

Rituximab in refractory chronic inflammatory demyelinating polyneuropathy

Rituximab in refractory chronic inflammatory demyelinating polyneuropathy

Rituximab in multiple sclerosis at general hospital level

Efficacy and safety of combined low‐dose rituximab regimen for chronic inflammatory demyelinating polyradiculoneuropathy

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