Rituximab reduces attacks in Chinese patients with neuromyelitis optica spectrum disorders

Division of Neurology, Department of Medicine & Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China.
Journal of the neurological sciences (Impact Factor: 2.47). 10/2012; 324(1-2). DOI: 10.1016/j.jns.2012.09.024
Source: PubMed


We evaluated the safety and efficacy of rituximab in seven Chinese patients with neuromyelitis optica (NMO) or neuromyelitis optica syndrome disorders (NMOSD) in a tertiary medical center in Hong Kong. After rituximab induction, five patients became relapse-free and two had 50% reduction of relapses over a median follow-up of 24 months. No further deterioration of functional status, measured by the Expanded Disability Status Scale, was observed in all patients. Infusions were well tolerated except in two patients who developed transient hypotension. Rituximab reduced clinical relapse and prevented neurological deterioration in a small cohort of Chinese patients with NMO or NMOSD.

Download full-text


Available from: Alexander Yuk-lun Lau,
  • [Show abstract] [Hide abstract]
    ABSTRACT: Autoantikörper gegen neuronale Strukturen gewinnen in der Differenzialdiagnostik und Klassifikation verschiedener neurologischer Erkrankungen zunehmend an Bedeutung, z. B. bei der Neuromyelitis optica, bei paraneoplastischen ZNS-Erkrankungen, beim Stiff-Person-Syndrom und bei Autoimmunepilepsien. Da es sich um seltene Syndrome handelt, liegen bislang keine ausreichend evidenzbasierten Therapiedaten vor. Zum aktuellen Zeitpunkt werden vorrangig verschiedene immunmodulatorische und -suppressive Substanzen angewendet, zusätzlich spielt bei paraneoplastischen Syndromen die Behandlung der zugrunde liegenden Krebserkrankung eine zentrale Rolle. Diese Übersicht dient der zusammenfassenden Darstellung der aktuellen Literatur hinsichtlich bisheriger Erfahrungen in der Behandlung und daraus abgeleiteten Therapieempfehlungen.
    Der Nervenarzt 04/2013; 84(4). DOI:10.1007/s00115-012-3608-4 · 0.79 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Introduction: Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system (CNS), traditionally considered to be an autoimmune disease. Despite the standard of care for patients with MS is significantly improved in recent years, there is still room for improvement in terms of effectiveness and also compliance. Areas covered: The continuous improvements of our understanding of the pathophysiological changes that occur in MS have translated into many novel therapeutic agents at different stages of development. A number of therapies for MS are in advanced development and likely to be available soon. Along with these, we have also seen the appearance of a group of drugs considered together as a consequence of their similar design: the monoclonal antibodies (mAbs). Here, the focus will be on reviewing results that have emerged from a better clarification of MS pathogenesis to clinical trials of different anti-CD20 mAbs. Expert opinion: The decision to switch established patients from well-known drugs to either new formulations or new agents will be made on balancing efficacy and tolerability of the existing treatments. Safety seems increasingly likely to become a key factor.
    Expert Opinion on Investigational Drugs 07/2013; 22(10). DOI:10.1517/13543784.2013.820275 · 5.53 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Azathioprine (AZA) is a common immunosuppressive drug used for relapse prevention in neuromyelitis optica (NMO). The objective of this paper is to assess efficacy, tolerability and retention of AZA in a large NMO cohort. We conducted a retrospective review of medical records of 103 aquaporin-4 antibody-positive NMO and NMO spectrum disorder (NMOSD) patients treated with AZA. This is the largest reported cohort of AQP4-Ab positive patients treated with AZA. Eighty-nine per cent (n = 92) had reduction in median annualised relapse rates from 1.5 (IQR 0.6-4.0) to 0 (IQR 0-0.27, p < 0.00005) with treatment. Sixty-one per cent (n = 63) remained relapse free at a median follow-up of 18 months. Neurological function improved or stabilised in 78%. At last follow-up, treatment was discontinued in 46% (n = 47). Of these, 62% (n = 29) were because of side effects, 19% (n = 9) because of death, 15% (n = 7) because of ongoing disease activity, and 2% (n = 1) because of pregnancy. Using Kaplan-Meyer curves, we estimate that 73%, 58%, 47% and 33% of patients will remain on AZA for longer than one, three, five and 10 years, respectively, after initiation of treatment. AZA is a modestly effective treatment for NMO. However, many patients discontinue AZA over time and this seems to reflect poor tolerability more than lack of efficacy.
    Multiple Sclerosis 03/2014; 20(11). DOI:10.1177/1352458514525870 · 4.82 Impact Factor
Show more