Rituximab in chronic inflammatory demyelinating polyradiculoneuropathy with associated diseases.

Abstract

We aimed to analyse the response to rituximab in a cohort of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) patients with associated disorders. We conducted a clinical and electrophysiological retrospective monocentric study in 28 CIDP patients. Response to rituximab was defined as (a) a five-point increase in the Medical Research Council sum score or a one-point decrease in the Overall Neuropathy Limitations Scale score, compared to the score at the first rituximab infusion, or (b) the discontinuation of, or reduced need for, the last treatments before rituximab initiation. Twenty-one patients (75%) were responders to rituximab. The median time before response was 6 months (1-10 months). Only two patients needed to be treated again during a median follow-up of 2.0 years (0.75-9 years). Interestingly, the response rate was good in patients with associated autoimmune disease (5/8) and similar to the response rate observed in patients with a haematological disease (16/20) (P = 0.63). A shorter disease duration was associated with a better clinical response to rituximab (odds ratio 0.81, P = 0.025) and the response rate was better (P = 0.05) in common forms (83.3%) than in sensory forms (42.9%). No major adverse events were recorded. Rituximab is efficacious in CIDP patients with haematological or autoimmune disease. It improves clinical response and decreases dependence on first-line treatments.

• Authors: Thomas Roux, Rabab Debs, Thierry Maisonobe, Timothée Lenglet, Cécile Delorme, Céline Louapre, Véronique Leblond, Karine Viala
• Journal: Journal of the peripheral nervous system : JPNS (J Peripher Nerv Syst) Vol. 23 Issue 4 Pg. 235-240 (12 2018) ISSN: 1529-8027 [Electronic] United States
• PMID: 30203907 (Publication Type: Journal Article)
• Copyright: © 2018 Peripheral Nerve Society.

Chemical References

• Immunoglobulins, Intravenous
• Immunosuppressive Agents
• Rituximab

Topics

• Adult
• Aged
• Aged, 80 and over
• Autoimmune Diseases (complications)
• Combined Modality Therapy
• Drug Evaluation
• Drug Therapy, Combination
• Female
• Follow-Up Studies
• Hematologic Diseases (complications)
• Humans
• Immunoglobulins, Intravenous (therapeutic use)
• Immunosuppressive Agents (therapeutic use)
• Male
• Middle Aged
• Neural Conduction
• Polyradiculoneuropathy, Chronic Inflammatory Demyelinating (complications, drug therapy, therapy)
• Retrospective Studies
• Rituximab (therapeutic use)
• Severity of Illness Index
• Treatment Outcome