title: Neurophysiological and clinical responses to rituximab in patients with anti-MAG polyneuropathy.
abstract: OBJECTIVE
  Rituximab treatment has shown clinical improvement in anti-myelin associated glycoprotein (MAG) polyneuropathy. We analyzed scores of clinical scales and the most sensitive electrophysiological parameters before and after immunomodulating treatment with rituximab in a group of patients affected by anti-MAG demyelinating polyneuropathy.
  
  
  METHODS
  Clinical scores, the percentage of CD20 B-lymphocytes, anti-MAG antibody titers and electrophysiological data in 7 patients with anti-MAG polyneuropathy were analyzed. The patients were examined before a cycle with rituximab, 6, 12 and 24 months after the end of the treatment. Two patients were treated with rituximab additional cycles and re-evaluated 48 months after the first treatment.
  
  
  RESULTS
  There were no evident correlation between anti-MAG serum antibody titers or clinical scales and electrodiagnostic data. Significant decrease in the proportion of CD20 B-lymphocytes was observed. Significant anti-MAG antibodies titers reduction was detected after re-treatment. At follow-up, pinprik sensation and two point discrimination presented a significant improvement compared with the score before treatment.
  
  
  CONCLUSIONS
  In our patients, rituximab did not improve any electrophysiological data. No correlation with anti-MAG serum antibodies course was found. With rituximab only pin sensibility improved.
  
  
  CONCLUSIONS
  Rituximab re-treatment significantly reduces anti-MAG serum antibodies titers but improves only small fibers sensibility.
authors.affiliation: Department of Neurosciences, University of Padova, Italy. gabriella.zara@sanita.padova.it
authors.forename: Gabriella
authors.initials: G
authors.lastname: Zara
authors.forename: Renato
authors.initials: R
authors.lastname: Zambello
authors.forename: M
authors.initials: M
authors.lastname: Ermani
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use*; D018951:Antigens, CD20 / Q000276:immunology; D001402:B-Lymphocytes / Q000187:drug effects / Q000276:immunology; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood / Q000276:immunology; D007155:Immunologic Factors / Q000627:therapeutic use*; D037102:Lectins / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D018992:Myelin-Associated Glycoprotein / Q000276:immunology*; D011115:Polyneuropathies / Q000188:drug therapy* / Q000503:physiopathology; D000069283:Rituximab; D016896:Treatment Outcome
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D018951:Antigens, CD20; D007075:Immunoglobulin M; D007155:Immunologic Factors; D037102:Lectins; C115082:MAG protein, human; D018992:Myelin-Associated Glycoprotein; D000069283:Rituximab