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Rituximab in patients with chronic inflammatory demyelinating polyradiculoneuropathy: a report of 13 cases and review of the literature
  1. L Benedetti1,
  2. C Briani2,
  3. D Franciotta3,
  4. R Fazio4,
  5. I Paolasso5,
  6. C Comi6,
  7. M Luigetti7,
  8. M Sabatelli7,
  9. F Giannini8,
  10. G L Mancardi9,
  11. A Schenone9,
  12. E Nobile-Orazio10,
  13. D Cocito5
  1. 1Department of Neurology, Osp. S. Andrea, La Spezia, Genova, Italy
  2. 2Department of Neurosciences, University of Padova, Italy
  3. 3Laboratory of Neuroimmunology, IRCCS, Neurological Institute “C. Mondino”, University of Pavia, Pavia, Italy
  4. 4Department of Neurology, IRCCS San Raffaele, Milano, Italy
  5. 5Neurologia I, Department of Neuroscience, A.S.O. San Giovanni Battista, Torino, Italy
  6. 6Interdisciplinary Research Center of Autoimmune Disease (IRCAD), A. Avogadro, University of Eastern Piedmont, Novara, Italy
  7. 7Department of Neuroscience, Catholic University, Roma, Italy
  8. 8Department of Neuroscience, University of Siena, Siena, Italy
  9. 9Department of Neuroscience, Ophtalmology and Genetics, Genova, Italy
  10. 10Department Neurological Sciences, Milan University, IRCCS Humanitas Clinical Institute, Rozzano, Milano, Italy
  1. Correspondence to Luana Benedetti, Department of Neurology, Osp. S. Andrea, Via Vittorio Veneto 197, 19100 La Spezia, Italy; luanabenedetti{at}libero.it

Abstract

Background A few case reports have shown controversial results of rituximab efficacy in patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP).

Objective To analyse the efficacy of rituximab in a large CIDP cohort.

Methods A retrospective, observational and multicentre study on the use of rituximab in CIDP. 13 Italian CIDP patients were treated with rituximab after the partial or complete lack of efficacy of conventional therapies. Eight patients had co-occurring haematological diseases. Patients who improved by at least two points in standard clinical scales, or who reduced or discontinued the pre-rituximab therapies, were considered as responders.

Results Nine patients (seven with haematological diseases) responded to rituximab: six of them, who were non-responders to conventional therapies, improved clinically, and the other three maintained the improvement that they usually achieved with intravenous immunoglobulin or plasma exchange. Significantly associated with shorter disease duration, rituximab responses started after a median period of 2.0 months (range, 1–6) and lasted for a median period of 1 year (range, 1–5).

Conclusions Rituximab seems to be a promising therapeutic choice when it targets both CIDP and co-occurring haematological diseases. Timely post-onset administration of rituximab seems to be associated with better responses.

  • Rituximab
  • CIDP
  • polyradiculoneuropathy
  • neuroimmunology
  • neuropathy

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Footnotes

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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