Prolonged Remission in Neuromyelitis Optica Following Cessation of Rituximab Treatment.

Abstract

Neuromyelitis optica is an autoimmune disease characterized by acute episodes of transverse myelitis and optic neuritis. Several small, open-label studies suggest rituximab, a monoclonal antibody against CD20, prevents relapses in neuromyelitis optica; however, there is little consensus on timing or duration of treatment. Here we report four patients with severe relapsing neuromyelitis optica who were stabilized on rituximab and, after discontinuing treatment, continued to experience prolonged remission of their disease. Remission ranged from 4.5 to 10.5 years total, including 3 to 9 years off all therapies. The patients had sustained clinical responses despite normal B-lymphocyte levels and, in at least 2 patients, continued seropositivity for aquaporin-4 antibodies. These cases suggest that rituximab may induce prolonged remission in certain neuromyelitis optica patients, and they highlight the need for further elucidation of rituximab's mechanism in neuromyelitis optica.

• Authors: Kelley Weinfurtner, Jennifer Graves, Jayne Ness, Lauren Krupp, Maria Milazzo, Emmanuelle Waubant
• Journal: Journal of child neurology (J Child Neurol) Vol. 30 Issue 10 Pg. 1366-70 (Sep 2015) ISSN: 1708-8283 [Electronic] United States
• PMID: 25387545 (Publication Type: Case Reports, Journal Article)
• Copyright: © The Author(s) 2014.

Chemical References

• AQP4 protein, human
• Aquaporin 4
• Immunologic Factors
• Rituximab

Topics

• Aquaporin 4 (metabolism)
• Child
• Child, Preschool
• Female
• Humans
• Immunologic Factors (administration & dosage)
• Male
• Middle Aged
• Neuromyelitis Optica (drug therapy, physiopathology)
• Remission Induction
• Rituximab (administration & dosage)