% 0期刊文章%一个孔雀舞Bhargava % Cassie Wicken %马修·史密斯%一个丹尼尔帝国艾琳Cortese % %彼得•卡拉布雷西%艾伦Mowry % T 1期临床试验的鞘内利妥昔单抗在进步,患者的证据Leptomeningeal对比度增强(P3.393) % D J神经病学2018% % P P3.393 % V 90% N 15补充% X目的:评估鞘内的安全(IT)利妥昔单抗(PMS)女士在进步。首页此外,评估影响的利妥昔单抗在leptomeningeal对比度增强(LME)检测到核磁共振,和脑脊液生物标记。背景:Leptomeningeal炎症与增加皮质髓鞘脱失,神经损伤和临床结果更糟,在发展女士暗示的作用。对比度增强天赋成像检测领域的LME对应于脑膜的炎症。因为B细胞有助于脑膜的炎症,我们假设它利妥昔单抗LME的可能影响。设计/方法:经前综合症患者筛查MRI检测LME的领域。那些LME满足合格标准经历了两个政府25毫克利妥昔单抗的2周。后续的腰椎穿刺和MRI进行第一次治疗后8 - 24周。我们评估了LME病变和多个脑脊液生物标志物水平变化在24周。结果:我们36 PMS患者,确定15 LME的筛选。十一答应了,和8满足合格标准,接受研究治疗。平均年龄为55.5岁(差:9.0)的数量和LME病变范围从1 - 3所示。 No serious adverse effects (AE) occurred.We noted a profound reduction in peripheral blood B cells from baseline (median:18.55%, IQR: 7.2) to week 2 (0.1%, IQR: 1.2) and 8 (0.1%, IQR: 0.8) with some return at 24 weeks (3.6%, IQR: 9.0). However, we noted no change in the number of LME following IT rituximab over the 24-week MRI follow up. We observed transient reductions in CSF B cells (p=0.018) and CXCL-13 levels (p=0.045) with an increase in BAFF levels (p=0.17) with treatment.Conclusions: IT rituximab was well tolerated in PMS patients and resulted in profound peripheral B cell depletion. IT rituximab had transient effects on CSF biomarkers but did not change LME detected on imaging. IT rituximab was insufficient to completely resolve meningeal inflammation in this small PMS cohort.Study Supported by: Grant from Race to Erase MS and Progressive MS Alliance to PC. Career Transition Award from NMSS to PB, John F Kurtzke Clinician Scientist Development Award to PB and Junior Faculty Award from Race to Erase MS to PB.Disclosure: Dr. Bhargava has nothing to disclose. Dr. Wicken has nothing to disclose. Dr. Smith has nothing to disclose. Dr Cortese has nothing to disclose. Dr. Reich has nothing to disclose. Dr. Calabresi has nothing to disclose. Dr. Mowry has received personal compensation in an editorial capacity for UpToDate (royalties). Dr. Mowry has received research support from Biogen, Genzyme, Teva, SunPharma. %U

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