Rituximab in refractory chronic inflammatory demyelinating polyneuropathy

Muscle Nerve. 2020 May;61(5):575-579. doi: 10.1002/mus.26804. Epub 2020 Jan 21.

Abstract

Introduction: Chronic inflammatory demyelinating polyneuropathy (CIDP) is a disorder in which early effective treatment is important to minimize disability from axonal degeneration. It has been suggested that some patients with CIDP may benefit from rituximab therapy, but there is no definitive evidence for this.

Methods: Baseline and post-rituximab-therapy neuromuscular Medical Research Council (MRC) sum scores, Inflammatory Neuropathy Cause and Treatment (INCAT) disability score, and functional status were assessed in 11 patients with refactory CIDP.

Results: The MRC sum score, INCAT disability score, and functional status improved in all patients after rituximab therapy.

Discussion: Our study provides evidence of the efficacy of rituximab therapy in at least some patients with CIDP. A placebo-controlled study to assess the effectiveness of rituximab therapy in CIDP with and without nodal antibodies is required to identify disease markers that predict responsiveness.

Keywords: CIDP; neuropathy; refractory; rituximab; treatment.

MeSH terms

  • Adult
  • Aged
  • Azathioprine / therapeutic use
  • Canes
  • Cyclophosphamide / therapeutic use
  • Female
  • Foot Orthoses
  • Glucocorticoids / therapeutic use
  • Humans
  • Immunoglobulins, Intravenous / therapeutic use
  • Immunologic Factors / therapeutic use*
  • Male
  • Middle Aged
  • Mobility Limitation*
  • Mycophenolic Acid / therapeutic use
  • Plasma Exchange
  • Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / drug therapy*
  • Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / etiology
  • Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / physiopathology
  • Quadriplegia / drug therapy*
  • Quadriplegia / etiology
  • Quadriplegia / physiopathology
  • Rituximab / therapeutic use*
  • Treatment Failure
  • Treatment Outcome
  • Walkers

Substances

  • Glucocorticoids
  • Immunoglobulins, Intravenous
  • Immunologic Factors
  • Rituximab
  • Cyclophosphamide
  • Mycophenolic Acid
  • Azathioprine