title: Efficacy of rituximab in refractory neuromyelitis optica.
abstract: Despite a growing use of rituximab (RTX) in neuromyelitis optica (NMO), data are lacking in patients with refractory NMO (RNMO), defined as cases with at least one relapse during immunosuppressive therapy.
  
  
  
  The purpose of this study was to assess RTX as a maintenance therapy in RNMO.
  
  
  
  Out of a total of 305 NMO cases from a population-based cohort, 21 RNMO patients received RTX during a mean follow-up period of 31 months.
  
  
  
  After RTX, 11 patients (52.3%) were relapse free, meaning that 47.7% were refractory to RTX. The mean annualized relapse rate decreased from 1.3 to 0.4 (p<0.001) and median EDSS from 5 to 3 (p=0.02). Body mass index (BMI) was predictive of EDSS worsening.
  
  
  
  RTX is an effective and well-tolerated treatment in RNMO. BMI could be a predictive factor for efficacy.
authors.affiliation: Department of Neurology, Hopital de Hautepierre, France nicolas.collongues@chru-Strasbourg.fr.
authors.forename: N
authors.initials: N
authors.lastname: Collongues
authors.affiliation: Department of Neurology, Hopital Purpan, France.
authors.forename: D
authors.initials: D
authors.lastname: Brassat
authors.affiliation: Department of Neurology, Hopital Pitie-Salpetriere, France.
authors.forename: E
authors.initials: E
authors.lastname: Maillart
authors.affiliation: Department of Neurology, Hopital Universitaire de Montpellier, France.
authors.forename: P
authors.initials: P
authors.lastname: Labauge
authors.affiliation: Department of Neurology, Centre Hospitalier Universitaire de Bordeaux, France.
authors.forename: J C
authors.initials: JC
authors.lastname: Ouallet
authors.affiliation: Department of Neurology, Hopital Universitaire de Montpellier, France.
authors.forename: C
authors.initials: C
authors.lastname: Carra-Dalliere
authors.affiliation: Department of Neurology, Hopital Universitaire de Dijon, France.
authors.forename: T
authors.initials: T
authors.lastname: Moreau
authors.affiliation: Department of Neurology, Hopital Charles Nicolle, France.
authors.forename: B
authors.initials: B
authors.lastname: Bourre
authors.affiliation: Department of Neurology, Hopital Pitie-Salpetriere, France.
authors.forename: C
authors.initials: C
authors.lastname: Papeix
authors.affiliation: Department of Neurology, Centre Hospitalier Universitaire de Bordeaux, France.
authors.forename: B
authors.initials: B
authors.lastname: Brochet
authors.affiliation: Department of Neurology, Hopital Universitaire de Marseille, France.
authors.forename: B
authors.initials: B
authors.lastname: Audoin
authors.affiliation: Department of neurology, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, France.
authors.forename: S
authors.initials: S
authors.lastname: Vukusic
authors.affiliation: Department of Neurology, Hopital de Hautepierre, France.
authors.forename: J
authors.initials: J
authors.lastname: de Seze
authors.affiliation: Department of neurology, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, France.
authors.forename: R
authors.initials: R
authors.lastname: Marignier
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D004185:Disability Evaluation; D018450:Disease Progression; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009471:Neuromyelitis Optica / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology; D012008:Recurrence; D012074:Remission Induction; D012307:Risk Factors; D000069283:Rituximab / Q000009:adverse effects / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents; D000069283:Rituximab
keywords: Neuromyelitis optica; body mass index; disability; refractory; rituximab