title: Monitoring CD27+ memory B-cells in neuromyelitis optica spectrum disorders patients treated with rituximab: Results from a bicentric study.
abstract: BACKGROUND
  Rituximab (RTX) is increasingly used in the treatment of neuromyelitis optica spectrum disorder (NMO-SD). Administration regimen is not consensual as there is no reliable biomarker of RTX efficacy. In most cases, after induction, RTX is administered systematically every 6months.
  
  
  OBJECTIVE
  To assess efficacy and safety of a maintenance regimen based on CD19+ CD27+ memory B-cell (mBc) detection.
  
  
  METHODS
  We conducted a study in two French centers, including patients with NMO-SD who received an induction therapy with RTX. We compared the number of administered infusions, relapses and EDSS depending on two maintenance schemes (S1: administration of 1g RTX infusion every 6months or S2: a scheme based on regular mBc detection. 1g RTX was administered if mBc was >0.05%) RESULTS: 40 patients were included (mean age: 40.2years, F/M sex ratio: 5/1). Aquaporin-4 antibodies were positive in 75% patients. Under S1 regimen, all patients received 2 infusions per year, whereas under S2, they received 1.62 infusion per year. The mean interval between infusions under S2 was 7.4months, without decrease of clinical efficacy.
  
  
  CONCLUSIONS
  In our study, mBc-based administration of RTX allowed personalizing treatment administration and in several cases to lower the cumulative dose without loss of efficacy.
authors.affiliation: Department of Neurology, Hôpital Pasteur 2, Nice, France. Electronic address: cohen.m@chu-nice.fr.
authors.forename: M
authors.initials: M
authors.lastname: Cohen
authors.affiliation: Department of Neurology, Hôpital Pasteur 2, Nice, France.
authors.forename: G
authors.initials: G
authors.lastname: Romero
authors.affiliation: Aix Marseille Univ, APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, 13005 Marseille, France.
authors.forename: J
authors.initials: J
authors.lastname: Bas
authors.affiliation: Department of Immunology, Hôpital l'Archet, Nice, France.
authors.forename: M
authors.initials: M
authors.lastname: Ticchioni
authors.affiliation: Department of Immunology, Hôpital l'Archet, Nice, France.
authors.forename: M
authors.initials: M
authors.lastname: Rosenthal
authors.affiliation: Hematology and Vascular Biology Department, CHU La Conception, Assistance Publique-Hôpitaux de Marseille, Marseille, France.
authors.forename: R
authors.initials: R
authors.lastname: Lacroix
authors.affiliation: Hematology and Vascular Biology Department, CHU La Conception, Assistance Publique-Hôpitaux de Marseille, Marseille, France.
authors.forename: C
authors.initials: C
authors.lastname: Brunet
authors.affiliation: Aix Marseille Univ, APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, 13005 Marseille, France.
authors.forename: A
authors.initials: A
authors.lastname: Rico
authors.affiliation: Aix Marseille Univ, APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, 13005 Marseille, France.
authors.forename: J
authors.initials: J
authors.lastname: Pelletier
authors.affiliation: Aix Marseille Univ, APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie, 13005 Marseille, France.
authors.forename: B
authors.initials: B
authors.lastname: Audoin
authors.affiliation: Department of Neurology, Hôpital Pasteur 2, Nice, France.
authors.forename: C
authors.initials: C
authors.lastname: Lebrun
mesh_terms: D000328:Adult; D018941:Antigens, CD19 / Q000032:analysis; D051401:Aquaporin 4 / Q000276:immunology; D001323:Autoantibodies / Q000097:blood; D016175:B-Lymphocyte Subsets / Q000187:drug effects* / Q000276:immunology; D015415:Biomarkers / Q000097:blood; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007155:Immunologic Factors / Q000008:administration & dosage* / Q000009:adverse effects; D007156:Immunologic Memory; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D009471:Neuromyelitis Optica / Q000188:drug therapy* / Q000276:immunology*; D057285:Precision Medicine / Q000379:methods*; D011446:Prospective Studies; D012008:Recurrence; D000069283:Rituximab / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome; D018127:Tumor Necrosis Factor Receptor Superfamily, Member 7 / Q000032:analysis; D055815:Young Adult
chemical_list: C496030:AQP4 protein, human; D018941:Antigens, CD19; D051401:Aquaporin 4; D001323:Autoantibodies; D015415:Biomarkers; C000604811:CD19 molecule, human; D007155:Immunologic Factors; D018127:Tumor Necrosis Factor Receptor Superfamily, Member 7; D000069283:Rituximab
keywords: Biomarkers; Health care costs; Immunology; Monoclonal antibodies; NMO; Rituximab