Rituximab for Polyneuropathy with IgM Monoclonal Gammopathy

Overview

Journal J Neurol Neurosurg Psychiatry

Publisher BMJ Publishing Group

Specialties Neurology
Neurosurgery
Psychiatry

Date 2009 Aug 18

PMID 19684235

Citations 11

Authors

J M F Niermeijer

M Eurelings

H L Lokhorst

W-L van der Pol

H Franssen

J H J Wokke

N C Notermans

Affiliations

Soon will be listed here.

Abstract

Background: Polyneuropathy with IgM monoclonal gammopathy can be a disabling disorder necessitating treatment.

Methods: In a prospective open label trial, 17 patients with disabling IgM MGUS polyneuropathy were treated with rituximab, a chimeric anti-CD-20 monoclonal antibody.

Results: Rituximab induced an improvement of >or=1 point on the Overall Disability Sum Score in 2/17 patients, an improvement of >or=5% of the distal MRC sum score in 4/17 and the sensory sum score in 9/17 patients. Bone marrow investigations showed CD 20 B cell depletion in all patients. There were no serious adverse events. Compared with treatment with intermittent cyclophosphamide with prednisone or treatment with fludarabine, it shows a comparable response percentages but fewer side effects. The presence of anti-MAG and a disease duration shorter than 10 years may predict treatment response.

Conclusion: Rituximab is a candidate for treatment of IgM MGUS polyneuropathy and should be further investigated in a double-blind randomised trial.

Citing Articles

The Role of Complement Activation in IgM M-Protein-Associated Neuropathies.

van de Mortel J, Budding K, Dijkxhoorn K, Minnema M, Vrancken A, Notermans N Neurol Neuroimmunol Neuroinflamm. 2024; 12(1):e200339.

PMID: 39571136 PMC: 11587989. DOI: 10.1212/NXI.0000000000200339.

Therapeutic Outcomes and Electrophysiological Biomarkers in Anti-Myelin-Associated Glycoprotein Neuropathy: A Multicenter Cohort Study in South Korea.

Min Y, Han H, Shin H, Baek J, Kim J, Park K J Clin Neurol. 2024; 20(1):50-58.

PMID: 38179632 PMC: 10782088. DOI: 10.3988/jcn.2023.0127.

Clinical, biological, electrophysiological and therapeutic profile of patients with anti-MAG neuropathy according to MYD88 and CXCR4 mutations and underlying haemopathy.

Gueremy A, Boucraut J, Boudjarane J, Grapperon A, Fortanier E, Farnault L J Neurol. 2023; 271(3):1320-1330.

PMID: 37979093 DOI: 10.1007/s00415-023-12068-4.

Efficacy of rituximab in anti-myelin-associated glycoprotein demyelinating polyneuropathy: Clinical, hematological and neurophysiological correlations during 2 years of follow-up.

Parisi M, Dogliotti I, Clerico M, Bertuzzo D, Benevolo G, Orsucci L Eur J Neurol. 2022; 29(12):3611-3622.

PMID: 36083713 PMC: 9825860. DOI: 10.1111/ene.15553.

Immunotherapy for IgM anti-myelin-associated glycoprotein paraprotein-associated peripheral neuropathies.

Lunn M, Nobile-Orazio E Cochrane Database Syst Rev. 2016; 10:CD002827.

PMID: 27701752 PMC: 6457998. DOI: 10.1002/14651858.CD002827.pub4.