Treatment of stiff person syndrome with rituximab

Baker, Mark R.

doi:10.1136/jnnp.2004.051144

Cited by 104 publications

(56 citation statements)

References 13 publications

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“…Because SPS is an antibody mediated disorder, it would be expected that plasmapheresis and rituximab would be reasonable treatments, and both have been used with reports of success [309,312].…”

Section: Stiff-person Syndromementioning

confidence: 99%

Immune Mediated Diseases and Immune Modulation in the Neurocritical Care Unit

Geldern¹,

McPharlin

Becker

2012

Neurotherapeutics

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This chapter will review the spectrum of immunemediated diseases that affect the nervous system and may result in an admission to the neurological intensive care unit. Immunomodulatory strategies to treat acute exacerbations of neurological diseases caused by aberrant immune responses are discussed, but strategies for long-term immunosuppression are not presented. The recommendations for therapeutic intervention are based on a synthesis of the literature, and include recommendations by the Cochrane Collaborative, the American Academy of Neurology, and other key organizations. References from recent publications are provided for the disorders and therapies in which randomized clinical trials and large evidenced-based reviews do not exist. The chapter concludes with a brief review of the mechanisms of action, dosing, and side effects of commonly used immunosuppressive strategies in the neurocritical care unit.

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Section: Stiff-person Syndromementioning

confidence: 99%

Immune Mediated Diseases and Immune Modulation in the Neurocritical Care Unit

Geldern¹,

McPharlin

Becker

2012

Neurotherapeutics

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“…Notably, these patients have not received immunomodulating drugs that could alter the immune response to GAD65. Of interest, a single case report on an SPS patient demonstrated a rapid decline of intrathecal GAD65 IgG antibodies following anti-CD20 treatment, which suggested a successful targeting and elimination of autoantibody producing B cells within the CNS (Baker 2005). Furthermore, clinical trials with B cell depletion in other autoimmune diseases, such as RA and SLE, reported that certain autoantibodies, anti-DNA and rheumatoid factor, decayed after anti-CD20 B cell therapy (Cambridge 2003;Sfikakis 2005;.…”

Section: Breaking Tolerance To Gad65mentioning

confidence: 99%

“…Plasmapheresis has been reported to be beneficial in some SPS patients, and in a case study the improvement of symptoms correlated with decreased GAD65 antibody levels (Dalakas 2009). Finally, anti-CD20 B cell therapy has been shown to be beneficial in reducing stiffness and increasing mobility, and resulted in disappearance of GAD65 IgG antibodies in patients with PER and SPS (Saidha 2008;Baker 2005). …”

Section: Gad65 Igg Antibodies and Gad65-specific T Cells In Spsmentioning

confidence: 99%

MS and clinically isolated syndromes: Shared specificity but diverging clonal patterns of virus‐specific IgG antibodies produced in vivo and by CSF B cells in vitro

Skorstad

Vandvik

Vartdal

et al. 2009

Euro J of Neurology

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Background: Intrathecal synthesis of oligoclonal IgG antibodies against measles virus (MeV), varicella zoster virus (VZV) and herpes simplex virus type‐1 (HSV‐1) is a characteristic feature multiple sclerosis (MS). Methods: We have used isoelectric focusing‐immunoblot to define the clonal patterns of IgG and of IgG antibodies to MeV, VZV and HSV‐1 in supernatants of in vitro cultures of peripheral blood lymphocytes (PBL) and cerebrospinal fluid (CSF) cells and in sera and CSF from three patients with MS and three patients with clinically isolated syndromes (CIS) suspective of demyelinating disease. Results: In vitro synthesis of IgG by PBL was not detected in any patient. In contrast, in vitro synthesis by CSF cells of oligoclonal IgG and oligoclonal IgG antibodies to one or two of the three viruses tested was observed in all six patients. The clonal patterns of the in vitro synthesized IgG and virus specific IgG differed to varying extent from those synthesized intrathecally in vivo. However, in each patient, the in vitro and in vivo intrathecally produced antibodies displayed specificity for the same viruses. The addition of B cell activating factor (BAFF) had no effect on the amounts or clonal patterns of either total IgG or virus‐specific IgG produced by CSF cells in vitro. Conclusion: Virus specific B cells capable of spontaneous IgG synthesis are clonally expanded in the CSF of patients with MS. The B‐cell repertoire in CSF samples is only partially representative of the intrathecal B‐cell repertoire.

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“…Corticosteroids have been successful in some patients with SPS 4 , but no controlled trial has been conducted to date. Benefit in individual cases with immunosuppressive agents such as rituximab, azathioprine, methotrexate, cyclophosphomide and mycophenolate mofetil have been reported but these drugs have not been validated systematically 16,17 .…”

Section: Stiff Person Syndromementioning

confidence: 99%

Pathogenicity of autoantibodies in neurological disorders

Chang

2014

J of Cey Coll of Phy

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Treatment of stiff person syndrome with rituximab

Cited by 104 publications

References 13 publications

Immune Mediated Diseases and Immune Modulation in the Neurocritical Care Unit

Immune Mediated Diseases and Immune Modulation in the Neurocritical Care Unit

MS and clinically isolated syndromes: Shared specificity but diverging clonal patterns of virus‐specific IgG antibodies produced in vivo and by CSF B cells in vitro

Pathogenicity of autoantibodies in neurological disorders

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