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Treatment of IgM antibody associated polyneuropathies using rituximab.
- Source :
-
Journal of neurology, neurosurgery, and psychiatry [J Neurol Neurosurg Psychiatry] 2003 Apr; Vol. 74 (4), pp. 485-9. - Publication Year :
- 2003
-
Abstract
- Objectives: Polyneuropathies with associated serum IgM antibodies are often difficult to treat. Rituximab is a monoclonal antibody directed against the B cell surface membrane marker CD20. Rituximab eliminates B cells from the circulation, and, over time, could reduce cells producing autoantibodies. This study tested the ability of rituximab to produce changes in serum antibody titres, and improvement in strength, in patients with neuromuscular disorders and IgM autoantibodies.<br />Methods: Over a period of two years, the authors evaluated changes in strength, measured by quantitative dynamometry, and concentrations of several types of serum antibodies in patients with polyneuropathies and serum IgM autoantibodies. Twenty one patients treated with rituximab were compared with 13 untreated controls.<br />Results: Treatment with rituximab was followed by improved strength (an increase of mean (SEM) 23% (2%)of normal levels of strength), a reduction in serum IgM autoantibodies (to 43% (4%) of initial values), and a reduction in total levels of IgM (to 55% (4%) of initial values). There was no change in levels of serum IgG antibodies. There were no major side effects, even though B cells were virtually eliminated from the circulation for periods up to two years.<br />Conclusions: In patients with IgM autoantibody associated peripheral neuropathies, rituximab treatment is followed by reduced serum concentrations of IgM, but not IgG, antibodies, and by improvement in strength. Additional studies, with placebo controls and blinded outcome measures, are warranted to further test the efficacy of rituximab treatment of IgM associated polyneuropathies.
- Subjects :
- Antibodies, Anti-Idiotypic blood
Antibodies, Monoclonal, Murine-Derived
Follow-Up Studies
Humans
Immunoglobulin M blood
Immunoglobulins blood
Musculoskeletal Physiological Phenomena drug effects
Outcome Assessment, Health Care
Polyneuropathies blood
Rituximab
Time Factors
Antibodies, Anti-Idiotypic adverse effects
Antibodies, Monoclonal therapeutic use
Antineoplastic Agents therapeutic use
Immunoglobulin M adverse effects
Polyneuropathies chemically induced
Polyneuropathies drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 0022-3050
- Volume :
- 74
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Journal of neurology, neurosurgery, and psychiatry
- Publication Type :
- Academic Journal
- Accession number :
- 12640069
- Full Text :
- https://doi.org/10.1136/jnnp.74.4.485