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Rituximab for Secondary Progressive Multiple Sclerosis

A Case Series

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Abstract

Background: While numerous substances have been developed for the treatment of relapsing-remitting multiple sclerosis over recent years, options are still limited for patients with secondary progressive multiple sclerosis (SPMS).

Objectives and Methods: In this observational study we present clinical and CSF findings in three patients with SPMS who were treated with rituximab for at least 15 months.

Results: During the observation period, no severe adverse effects occurred and the Expanded Disability Status Scale (EDSS) score stabilized in all patients after a dramatic increase over the previous years. In contrast to other publications, we showed that the time to reoccurrence of B cells was very variable and that serial CSF examinations in the course of treatment revealed a decline in intrathecal IgG synthesis.

Conclusion: Rituximab seems to be effective in active SPMS. Restitution of the pathogenic immune response after administration of rituximab is variable. Further studies are needed to determine the optimal dosage and timing for rituximab therapy in multiple sclerosis.

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Acknowledgements

No funding was received to conduct this study. The authors have no conflicts of interest that are directly relevant to the content of this study.

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Authors and Affiliations

  1. Department of Neurology, University of Rostock, Rostock, Germany

    Paulus S. Rommer, Robert Patejdl, Alexander Winkelmann, Reiner Benecke & Uwe K. Zettl

  2. Department of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria

    Paulus S. Rommer

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  1. Paulus S. Rommer
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  2. Robert Patejdl
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  3. Alexander Winkelmann
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  4. Reiner Benecke
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  5. Uwe K. Zettl
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Correspondence to Paulus S. Rommer.

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Rommer, P.S., Patejdl, R., Winkelmann, A. et al. Rituximab for Secondary Progressive Multiple Sclerosis. CNS Drugs 25, 607–613 (2011). https://doi.org/10.2165/11589390-000000000-00000

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