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Abstract
Objective: To determine the effect of a lower dose of rituximab in depleting B lymphocytes, maintaining low B-cell counts, and relapse in patients with neuromyelitis optica (NMO) and NMO spectrum disorders.
Methods: We treated 5 Chinese patients with deteriorating NMO and NMO spectrum disorders with a 100-mg IV infusion of rituximab once a week for 3 consecutive weeks, followed by additional infusion of the same dosage depending on circulating B-cell repopulation.
Results: This reduced dosage of rituximab was sufficient to deplete B cells and maintain low B-cell counts. None of the treated patients experienced relapse, and all patients exhibited stabilized or improved neurologic function during the 1-year follow-up period. MRI revealed the absence of new lesions, no enhancement in spinal cord and brain, a significant shrinkage of spinal cord segments, and a reduction/disappearance of previous brain lesions.
Conclusion: A lower dosage of rituximab may be sufficient in depleting B cells, maintaining low B-cell counts, and preventing disease progression in Chinese patients with NMO.
GLOSSARY
- EDSS=
- Expanded Disability Status Scale;
- MS=
- multiple sclerosis;
- NMO=
- neuromyelitis optica
Footnotes
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
- Received January 10, 2013.
- Accepted in final form May 8, 2013.
- © 2013 American Academy of Neurology
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Letters: Rapid online correspondence
- Could reduced dosage really work?
- Reply to: Uncertainly regarding the clinical efficacy and B cell depletion of low-dose rituximab therapy in neuromyelitis optica
- Uncertainty regarding the clinical efficacy and B cell depletion of low-dose rituximab therapy in neuromyelitis optica
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