Renaud Susanne, Gregor Michael, Fuhr Peter, Lorenz Delia, Deuschl Günther, Gratwohl Alois, Steck Andreas J
Department of Neurology, University Hospital Basel, Petersgraben 4, CH-4031 Basel, Switzerland.
Muscle Nerve. 2003 May;27(5):611-5. doi: 10.1002/mus.10359.
No causative or curative therapy exists for the polyneuropathy associated with antibodies to myelin-associated glycoprotein (anti-MAG). Rituximab is a mouse-human chimeric antibody that specifically eliminates B-cells and B-cell precursors. Preliminary results suggest a beneficial effect on antibody-dependent autoimmune diseases. Nine patients with an anti-MAG-associated IgM polyneuropathy received rituximab once weekly for 4 weeks. In all patients, the number of B-cells in the peripheral blood declined below levels of detection, and the IgM levels decreased between 35% and 82% (median, 58%). In eight patients, lowering of the anti-MAG antibody titers of more than 52% was observed. Clinical status improved in six patients, remained stable in two, and worsened in one. The motor nerve conduction velocity improved by at least 10% in one ulnar nerve in seven patients and worsened in two. Rituximab was well tolerated and is a promising new drug in the treatment of patients with anti-MAG-associated polyneuropathy.
对于与髓鞘相关糖蛋白抗体（抗MAG）相关的多发性神经病，不存在病因治疗或治愈性疗法。利妥昔单抗是一种鼠 - 人嵌合抗体，可特异性清除B细胞和B细胞前体。初步结果表明其对抗体依赖性自身免疫性疾病有有益作用。9例抗MAG相关IgM多发性神经病患者接受利妥昔单抗治疗，每周1次，共4周。所有患者外周血B细胞数量降至检测水平以下，IgM水平下降35%至82%（中位数为58%）。8例患者抗MAG抗体滴度降低超过52%。6例患者临床状况改善，2例保持稳定，1例恶化。7例患者的一条尺神经运动神经传导速度至少提高了10%，2例恶化。利妥昔单抗耐受性良好，是治疗抗MAG相关多发性神经病患者的一种有前景的新药。
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