title: Clinical evaluation of rituximab treatment for neuromyelitis optica.
abstract: BACKGROUND
  Neuromyelitis optica is an inflammatory and usually relapsing demyelinating autoimmune disease of the central nervous system that targets the optic nerves and spinal cord. Rituximab has been used for different neurological diseases that are probably immune-mediated or involving humoural immunity. The objective of this study is to evaluate the efficacy and safety of rituximab as treatment for neuromyelitis optica in a tertiary hospital.
  
  
  METHODS
  Retrospective study of patients with neuromyelitis optica treated with rituximab 1000mg on days 1 and 15, repeated every 6 to 8 months. We recorded EDSS score, relapse rate, overall condition, CD19+ count, presence of anti-NMO antibodies, and possible adverse reactions.
  
  
  RESULTS
  Six patients were treated; all were women with a median age of 46 years (range, 38-58). Anti-NMO antibodies were detected in 3 patients (50%). Baseline EDSS was 4 (range 2.0-5.5). Two patients had previously been treated with an immunomodulatory drug. Median time from the first rituximab infusion to first relapse was 3.7 years (range 1.7-6.9). Two patients had infusion reactions after the first dose of rituximab. Four patients remained relapse-free and their EDSS score did not progress during rituximab treatment, one patient showed no clinical improvement, and one patient could not be evaluated.
  
  
  CONCLUSIONS
  Rituximab can be considered an attractive therapeutic alternative for patients with neuromyelitis optica as there are no approved treatments for this disease. Further studies with rituximab are needed to establish the role of this drug in treating neuromyelitis optica.
authors.affiliation: Servicio de Farmacia, Hospital Universitari i Politècnic La Fe, Valencia, España. Electronic address: fernandez_marmeg@gva.es.
authors.forename: M J
authors.initials: MJ
authors.lastname: Fernández-Megía
authors.affiliation: Servicio de Neurología, Hospital Universitari i Politècnic La Fe, Valencia, España.
authors.forename: B
authors.initials: B
authors.lastname: Casanova-Estruch
authors.affiliation: Servicio de Neurología, Hospital Universitari i Politècnic La Fe, Valencia, España.
authors.forename: F
authors.initials: F
authors.lastname: Pérez-Miralles
authors.affiliation: Servicio de Farmacia, Hospital Universitari i Politècnic La Fe, Valencia, España.
authors.forename: J
authors.initials: J
authors.lastname: Ruiz-Ramos
authors.affiliation: Servicio de Neurología, Hospital Universitari i Politècnic La Fe, Valencia, España.
authors.forename: C
authors.initials: C
authors.lastname: Alcalá-Vicente
authors.affiliation: Servicio de Farmacia, Hospital Universitari i Politècnic La Fe, Valencia, España.
authors.forename: J L
authors.initials: JL
authors.lastname: Poveda-Andrés
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D008875:Middle Aged; D009471:Neuromyelitis Optica / Q000188:drug therapy*; D012189:Retrospective Studies; D000069283:Rituximab / Q000627:therapeutic use*
chemical_list: D007155:Immunologic Factors; D000069283:Rituximab
keywords: Effectiveness; Eficacia; Neuromielitis óptica; Neuromyelitis optica; Rituximab