Treatment Outcomes With Rituximab in 100 Patients With Neuromyelitis Optica

Abstract

Rituximab is a chimeric monoclonal anti-CD20 antibody that has been proposed as an effective therapy for neuromyelitis optica spectrum disorder (NMOSD). Previous data have been based mostly on small case series with short-term follow-up.^1-10 There has been concern about the variability of rituximab responses.^6,7 Previously, we reported the therapeutic efficacy of rituximab in 30 patients with NMOSD across a 5-year period and the depletion of memory B cells in peripheral blood was associated with a clinical response to rituximab.^3,5 However, not all patients respond to rituximab treatment and the durability of the memory B-cell depletion is variable.^3,5 The reason for this variability in rituximab response and the question of who will benefit from a lower and more cost-effective dose of rituximab is unresolved.