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Published on: June 29, 2016
Rituximab for polyneuropathy with IgM monoclonal gammopathy
J M F Niermeijer1, M Eurelings, H L Lokhorst
1Department of Neurology and Rudolf Magnus Institute of Neurosciences, University Medical Center Utrecht, Utrecht, The Netherlands. j.m.f.niermeijer@umcutrecht.nl
Rituximab shows promise for treating IgM monoclonal gammopathy (MGUS) polyneuropathy, a disabling condition. This treatment led to symptom improvement in some patients with manageable side effects, warranting further study.
Area of Science:
- Neurology
- Immunology
- Hematology
Background:
- IgM monoclonal gammopathy (MGUS) polyneuropathy is a disabling neurological disorder.
- Effective treatments are needed for this condition.
Purpose of the Study:
- To evaluate the efficacy and safety of rituximab in patients with disabling IgM MGUS polyneuropathy.
Main Methods:
- A prospective open-label trial involving 17 patients with IgM MGUS polyneuropathy.
- Patients were treated with rituximab, a chimeric anti-CD-20 monoclonal antibody.
Main Results:
- Rituximab improved disability scores in 2/17 patients and motor/sensory scores in 4/17 and 9/17 patients, respectively.
- CD20 B cell depletion was observed in all patients with no serious adverse events.
- Treatment showed comparable response rates to cyclophosphamide/prednisone or fludarabine but with fewer side effects.
- Anti-MAG antibodies and disease duration <10 years may predict treatment response.
Conclusions:
- Rituximab is a potential treatment for IgM MGUS polyneuropathy.
- Further investigation in a double-blind randomized trial is recommended.
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