title: Rituximab as first-line therapy in neuromyelitis optica: efficiency and tolerability.
abstract: Neuromyelitis optica (NMO) is a life-threatening disease without any validated treatment strategy. Recent retrospective studies suggested the efficacy of B cell depletion without any distinction between first-line or rescue therapy. To assess whether rituximab as first-line therapy in NMO could efficiently control the occurrence of relapses. A retrospective analysis of NMO patients from NOMADMUS network found 32 patients receiving rituximab as first-line therapy. Main measures were number of relapse-free patients, changes in the annualized relapse rate (ARR), and changes in the EDSS. Tolerance was reported. At baseline, NMO patients were 45 ± 12.1 years old, with a sex ratio of 5.4, and 87.5 % of them had AQP4 antibodies. The median disease duration was 6.5 months (1-410), the mean EDSS was 5.8 ± 2.4 and the mean ARR was 3.8 ± 4.3. After rituximab with a mean follow-up of 28.7 ± 21 months, twenty-seven patients (84.3 %) were relapse free. Patients presented a 97 % decrease of ARR (p = 0.00001). EDSS decreased significantly to 3.9 ± 2.6 (p = 0.01). No relevant side effect was noted. New retrospective data are presented on RTX use in NMOSD. When used as first-line therapy RTX is highly effective and well tolerated.
authors.affiliation: Clinique Neurologique, Hôpital Roger Salengro, CHRU de Lille, Université de Lille, Lille, France. helene.zephir@chru-lille.fr.
authors.forename: Hélène
authors.initials: H
authors.lastname: Zéphir
authors.affiliation: Pole des Neurosciences, CHU Toulouse and UMR 1043, Université de Toulouse III, Toulouse, France.
authors.forename: Raphaël
authors.initials: R
authors.lastname: Bernard-Valnet
authors.affiliation: Service de Neurologie, Hôpital Pasteur, CHU de Nice, Nice, France.
authors.forename: Christine
authors.initials: C
authors.lastname: Lebrun
authors.affiliation: Clinique Neurologique, Hôpital Roger Salengro, CHRU de Lille, Université de Lille, Lille, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Outteryck
authors.affiliation: Service de Neurologie, Hôpital Universitaire de la Timone, Marseille, France.
authors.forename: Bertrand
authors.initials: B
authors.lastname: Audoin
authors.affiliation: Service de Neurologie, CHU de Rouen, Rouen, France.
authors.forename: Bertrand
authors.initials: B
authors.lastname: Bourre
authors.affiliation: Service de Neurologie, Hôpital Central, Nancy, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Pittion
authors.affiliation: Service de Neurologie, CHU de Nantes, Nantes, France.
authors.forename: Sandrine
authors.initials: S
authors.lastname: Wiertlewski
authors.affiliation: Service de Neurologie, CHU de Bordeaux, Bordeaux, France.
authors.forename: Jean Christophe
authors.initials: JC
authors.lastname: Ouallet
authors.affiliation: Service de Neurologie, CHU de Poitiers, Poitiers, France.
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Neau
authors.affiliation: Service de Neurologie, CHU de Poitiers, Poitiers, France.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Ciron
authors.affiliation: Service de Neurologie, CHU de Clermont-Ferrand, Clermont-Ferrand, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Clavelou
authors.affiliation: Service de Neurologie, Hôpital Wertheimer, Hospices Civils de Lyon, Bron, France.
authors.forename: Romain
authors.initials: R
authors.lastname: Marignier
authors.affiliation: Pole des Neurosciences, CHU Toulouse and UMR 1043, Université de Toulouse III, Toulouse, France.
authors.forename: David
authors.initials: D
authors.lastname: Brassat
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007155:Immunologic Factors / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D009471:Neuromyelitis Optica / Q000188:drug therapy*; D017063:Outcome Assessment, Health Care; D012008:Recurrence; D000069283:Rituximab / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*
chemical_list: D007155:Immunologic Factors; D000069283:Rituximab
keywords: Aquaporin 4; B Cell depletion; Immunosuppression; Neuromyelitis optica; Relapse free; Rituximab