title: Intrathecal rituximab therapy in multiple sclerosis: review of evidence supporting the need for future trials.
abstract: Rituximab has demonstrated a major effect in B-cell lymphoma and in a wide range of autoimmune disorders. Unfortunately, the blood-brain-barrier excludes the disorders restricted to the central nervous system (CNS) from the action of rituximab. The progressive phase of multiple sclerosis (MS) is a prototypical CNS autoimmune disorder characterized by an intrathecal compartmentalization of inflammation resisting all the available immunosuppressive treatments. As a consequence, intrathecal therapeutics are promising new approach in progressive MS. We first review data gathered from animal models and human off-label intrathecal rituximab use in CNS lymphomas, then summarize the recent evidence supporting the need for trials based on the intrathecal use of rituximab in multiple sclerosis. The experience obtained in these settings offers valuable preliminary data for future studies in CNS autoimmunity.
authors.forename: Mickael
authors.initials: M
authors.lastname: Bonnan
authors.forename: Sylvie
authors.initials: S
authors.lastname: Ferrari
authors.forename: Eric
authors.initials: E
authors.lastname: Bertandeau
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Demasles
authors.forename: Elsa
authors.initials: E
authors.lastname: Krim
authors.forename: Marie
authors.initials: M
authors.lastname: Miquel
authors.affiliation: Service de Neurologie, Hopital F. Mitterrand, 4 bd Hauterive, 64046 Pau, France. mickael_bonnan@yahoo.fr.
authors.forename: Bruno
authors.initials: B
authors.lastname: Barroso
mesh_terms: D000818:Animals; D058846:Antibodies, Monoclonal, Murine-Derived / Q000493:pharmacokinetics* / Q000627:therapeutic use; D001812:Blood-Brain Barrier / Q000187:drug effects* / Q000473:pathology; D002986:Clinical Trials as Topic; D006801:Humans; D007155:Immunologic Factors / Q000493:pharmacokinetics* / Q000627:therapeutic use; D007278:Injections, Spinal; D016393:Lymphoma, B-Cell / Q000188:drug therapy / Q000473:pathology; D009103:Multiple Sclerosis / Q000188:drug therapy / Q000473:pathology*; D000069283:Rituximab
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D007155:Immunologic Factors; D000069283:Rituximab