Rituximab as a first-line preventive treatment in pediatric NMOSDs:… – PubMed – NCBI.
Rituximab as a first-line preventive treatment in pediatric NMOSDs: Preliminary results in 5 children.
Author information
- 1Neuroimaging Research Unit, Institute of Experimental Neurology, and Department of Neurology, Division of Neuroscience (G.L., M.F.), San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy; Department of Pediatrics (G.L., E.A.Y.), University of Toronto, and Division of Neurology (G.L., E.A.Y.), The Hospital for Sick Children, Toronto, Ontario, Canada; and Division of Neurology (B.B.), Children‘s Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA.
Abstract
OBJECTIVE:
No established therapeutic protocol has been proposed to date for childhood-onset neuromyelitis optica (NMO) spectrum disorders (NMOSDs). We report the response of 5 NMO immunoglobulin (Ig)G-positive pediatric cases to a standardized B-cell-targeted first-line immunosuppressive protocol with rituximab for prevention of relapses.
METHODS:
Retrospective observational cohort study.
RESULTS:
All patients included in the study showed disease remission after rituximab induction. Relapses always occurred in conjunction with CD19(+) B-cell repopulation and appeared less severe than prior to treatment. At the end of follow-up, neurologic disability and MRI findings stabilized or improved in all the patients, with only minor and transient side effects. Oral steroid discontinuation was possible in all the patients.
CONCLUSIONS:
Our protocol is well-tolerated and has provided encouraging results in terms of control of relapses and progression of disability. An early intervention with rituximab might affect the disease course in pediatric NMO-IgG-positive NMOSDs.
CLASSIFICATION OF EVIDENCE:
This study provides Class IV evidence that for children with NMOSDs, rituximab is well-tolerated and stabilizes or improves neurologic disability.
- PMID:
- 25520954
- [PubMed]
- PMCID:
- PMC4268036