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Rituximab in chronic inflammatory demyelinating polyradiculoneuropathy with associated diseases
Author(s) -
Roux Thomas,
Debs Rabab,
Maisonobe Thierry,
Lenglet Timothée,
Delorme Cécile,
Louapre Céline,
Leblond Véronique,
Viala Karine
Publication year - 2018
Publication title -
journal of the peripheral nervous system
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1
H-Index - 67
eISSN - 1529-8027
pISSN - 1085-9489
DOI - 10.1111/jns.12287
Subject(s) - rituximab , medicine , polyradiculoneuropathy , discontinuation , adverse effect , retrospective cohort study , cohort , odds ratio , gastroenterology , immunology , lymphoma , guillain barre syndrome
We aimed to analyse the response to rituximab in a cohort of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) patients with associated disorders. We conducted a clinical and electrophysiological retrospective monocentric study in 28 CIDP patients. Response to rituximab was defined as (a) a five‐point increase in the Medical Research Council sum score or a one‐point decrease in the Overall Neuropathy Limitations Scale score, compared to the score at the first rituximab infusion, or (b) the discontinuation of, or reduced need for, the last treatments before rituximab initiation. Twenty‐one patients (75%) were responders to rituximab. The median time before response was 6 months (1‐10 months). Only two patients needed to be treated again during a median follow‐up of 2.0 years (0.75‐9 years). Interestingly, the response rate was good in patients with associated autoimmune disease (5/8) and similar to the response rate observed in patients with a haematological disease (16/20) ( P = 0.63). A shorter disease duration was associated with a better clinical response to rituximab (odds ratio 0.81, P = 0.025) and the response rate was better ( P = 0.05) in common forms (83.3%) than in sensory forms (42.9%). No major adverse events were recorded. Rituximab is efficacious in CIDP patients with haematological or autoimmune disease. It improves clinical response and decreases dependence on first‐line treatments.