title: Beneficial effect of rituximab monotherapy in multifocal motor neuropathy.
abstract: Multifocal motor neuropathy (MMN) is a chronic, pure motor, asymmetric neuropathy for which intravenous immunoglobulin (IVIg) is widely regarded as first-line treatment. Rituximab is a monoclonal antibody against CD20+ cells that causes prolonged B cell depletion, a well-tolerated therapy currently explored in several immune-mediated neurologic disorders. We report three patients with MMN, who had become increasingly less responsive to IVIg but showed sustained clinical improvement following rituximab monotherapy. We provide a review of the literature on rituximab for MMN and conclude that rituximab may represent an efficacious, well-tolerated and cost-effective therapeutic option for MMN patients with declining response to IVIg.
authors.affiliation: Department of Neurology, Academic Teaching Hospital Wagner-Jauregg, Wagner-Jauregg-Weg 15, Linz, Austria.
authors.forename: Karl
authors.initials: K
authors.lastname: Stieglbauer
authors.forename: Raffi
authors.initials: R
authors.lastname: Topakian
authors.forename: Georg
authors.initials: G
authors.lastname: Hinterberger
authors.forename: Franz T
authors.initials: FT
authors.lastname: Aichner
mesh_terms: D000328:Adult; D000911:Antibodies, Monoclonal / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics; D058846:Antibodies, Monoclonal, Murine-Derived; D018951:Antigens, CD20 / Q000276:immunology; D001369:Axons / Q000187:drug effects / Q000276:immunology / Q000473:pathology; D001402:B-Lymphocytes / Q000187:drug effects / Q000276:immunology; D002452:Cell Count; D049109:Cell Proliferation / Q000187:drug effects; D003362:Cost-Benefit Analysis; D004351:Drug Resistance / Q000187:drug effects / Q000276:immunology; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007155:Immunologic Factors / Q000008:administration & dosage / Q000009:adverse effects / Q000191:economics; D007165:Immunosuppression Therapy / Q000379:methods*; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics; D008297:Male; D016472:Motor Neuron Disease / Q000188:drug therapy* / Q000276:immunology / Q000503:physiopathology; D009046:Motor Neurons / Q000187:drug effects / Q000276:immunology / Q000473:pathology; D010525:Peripheral Nerves / Q000187:drug effects / Q000276:immunology / Q000503:physiopathology; D010523:Peripheral Nervous System Diseases / Q000188:drug therapy* / Q000276:immunology / Q000503:physiopathology; D000069283:Rituximab; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D018951:Antigens, CD20; D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors; D007166:Immunosuppressive Agents; D000069283:Rituximab