Predictors of response to rituximab in patients with neuropathy and anti–myelin associated glycoprotein immunoglobulin M

L Benedetti, C Briani, M Grandis, T Vigo… - Journal of the …, 2007 - Wiley Online Library
L Benedetti, C Briani, M Grandis, T Vigo, M Gobbi, E Ghiglione, M Carpo, D Cocito…
Journal of the Peripheral Nervous System, 2007Wiley Online Library
We evaluated the efficacy and safety of rituximab in an open‐label, uncontrolled study of 13
patients with polyneuropathy associated with antibodies to myelin‐associated glycoprotein
(MAG) and correlated the response to therapy with clinical and laboratory features. One year
after rituximab therapy, anti‐MAG immunoglobulin M (IgM) titers were significantly reduced.
At that time, eight patients (62%) had improved in both the inflammatory neuropathy cause
and treatment (INCAT) sensory sumscore and the Medical Research Council sumscore for …
Abstract
We evaluated the efficacy and safety of rituximab in an open‐label, uncontrolled study of 13 patients with polyneuropathy associated with antibodies to myelin‐associated glycoprotein (MAG) and correlated the response to therapy with clinical and laboratory features. One year after rituximab therapy, anti‐MAG immunoglobulin M (IgM) titers were significantly reduced. At that time, eight patients (62%) had improved in both the inflammatory neuropathy cause and treatment (INCAT) sensory sumscore and the Medical Research Council sumscore for muscle strength and seven of them also in the INCAT disability score. The improvement in the mean INCAT sensory sumscore was significant at 12 months and correlated with lower anti‐MAG antibody at entry and at follow‐up. This study suggests that rituximab may be efficacious in patients with anti–MAG associated neuropathy and particularly on sensory impairment and in those with moderately elevated antibody titers. These findings suggest that antibody reduction below a critical level may be necessary to achieve clinical improvement.
Wiley Online Library