Beneficial effect of rituximab monotherapy in multifocal motor neuropathy

Neuromuscul Disord. 2009 Jul;19(7):473-5. doi: 10.1016/j.nmd.2009.04.013. Epub 2009 May 24.

Abstract

Multifocal motor neuropathy (MMN) is a chronic, pure motor, asymmetric neuropathy for which intravenous immunoglobulin (IVIg) is widely regarded as first-line treatment. Rituximab is a monoclonal antibody against CD20+ cells that causes prolonged B cell depletion, a well-tolerated therapy currently explored in several immune-mediated neurologic disorders. We report three patients with MMN, who had become increasingly less responsive to IVIg but showed sustained clinical improvement following rituximab monotherapy. We provide a review of the literature on rituximab for MMN and conclude that rituximab may represent an efficacious, well-tolerated and cost-effective therapeutic option for MMN patients with declining response to IVIg.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antibodies, Monoclonal / administration & dosage*
  • Antibodies, Monoclonal / adverse effects
  • Antibodies, Monoclonal / economics
  • Antibodies, Monoclonal, Murine-Derived
  • Antigens, CD20 / immunology
  • Axons / drug effects
  • Axons / immunology
  • Axons / pathology
  • B-Lymphocytes / drug effects
  • B-Lymphocytes / immunology
  • Cell Count
  • Cell Proliferation / drug effects
  • Cost-Benefit Analysis
  • Drug Resistance / drug effects
  • Drug Resistance / immunology
  • Humans
  • Immunoglobulins, Intravenous / therapeutic use
  • Immunologic Factors / administration & dosage
  • Immunologic Factors / adverse effects
  • Immunologic Factors / economics
  • Immunosuppression Therapy / methods*
  • Immunosuppressive Agents / administration & dosage*
  • Immunosuppressive Agents / adverse effects
  • Immunosuppressive Agents / economics
  • Male
  • Motor Neuron Disease / drug therapy*
  • Motor Neuron Disease / immunology
  • Motor Neuron Disease / physiopathology
  • Motor Neurons / drug effects
  • Motor Neurons / immunology
  • Motor Neurons / pathology
  • Peripheral Nerves / drug effects
  • Peripheral Nerves / immunology
  • Peripheral Nerves / physiopathology
  • Peripheral Nervous System Diseases / drug therapy*
  • Peripheral Nervous System Diseases / immunology
  • Peripheral Nervous System Diseases / physiopathology
  • Rituximab
  • Treatment Outcome

Substances

  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Murine-Derived
  • Antigens, CD20
  • Immunoglobulins, Intravenous
  • Immunologic Factors
  • Immunosuppressive Agents
  • Rituximab