Rituximab for the Treatment of Neuromyelitis Optica Spectrum Disorder
Su-Hyun Kim, MD, PhD, Jae-Won Hyun, MD, Ho Jin Kim, MD, PhD
Department of Neurology, Research Institute and Hospital of National Cancer Center, Goyang, Korea
Neuromyelitis optica spectrum disorder (NMOSD) is a rare inflammatory autoimmune disorder of the
central nervous system that predominantly affects the spinal cord, optic nerve and area postrema.
Convergent clinical and laboratory-based investigations have indicated that B cells play a fundamental
role in NMOSD immunopathology. Accordingly, biologic agents that target B cells are expected
to modulate NMOSD disease activity. Rituximab is a chimeric monoclonal antibody that targets
the CD20 molecule expressed on the surface of B cells and selectively depleted B cells. Recent
retrospective studies suggested robust long-term efficacy and acceptable safety profile of rituximab
therapy in NMOSD. Nevertheless, the place of rituximab in the treatment algorithm of NMOSD, the
optimal dose of rituximab, and the optimal interval for retreatment remain somewhat uncertain.
Monitoring rituximab treatment response with CD19+ or CD27+ B cell counts appears to improve
treatment outcomes. In the present review, we describe the state of the art about rituximab treatment
in NMOSD on the literature and authors’ experience and pose questions that would need to be addressed
in future studies.
Journal of Multiple Sclerosis 8(1):1-8, 2017
keyword : Neuromyelitis optica spectrum disorder, Rituximab, B cell
