Du Ying, Yan Qi, Li Chuan, Zhu Wenping, Zhao Chao, Hao Yunfeng, Li Lin, Yao Dan, Zhou Xuan, Li Ying, Dang Yuting, Zhang Rong, Han Lin, Wang Yuanyuan, Hou Tao, Li Juan, Li Hailin, Jiang Panpan, Wang Pei, Chen Fenying, Zhu Tingge, Liu Juntong, Liu Shuyu, Gao Lan, Zhao Yingjun, Zhang Wei
Department of Neurology, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, Shaanxi, China.
Xi'an Medical University, Xi'an, 710021, Shaanxi, China.
Ann Clin Transl Neurol. 2025 Jan;12(1):180-191. doi: 10.1002/acn3.52270. Epub 2024 Dec 11.
To determine the efficacy and safety of combined low-dose rituximab with conventional therapy for chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) treatment.
Total 73 patients with CIDP were enrolled for the retrospective cohort study, and divided into conventional first-line therapy cohort (n = 40) and combined low-dose rituximab (100 mg per infusion) cohort (n = 33). The outcome measures include scores of I-RODS, mRS, INCAT, ONLS, TSS, and COMPASS 31 scale at baseline and regular four visits (4, 16, 28, and 52 weeks), as well as proportion of favorable response and outcome, corticosteroids dosage, and deterioration occurrence during follow-up.
Compared to conventional therapy cohort, combined rituximab cohort presented better improvements and higher proportion of favorable response in scales assessments at each visit, as well as significantly reduced corticosteroids dosage and deterioration occurrence during the follow-up. Analyses of subgroups showed better improvements in both typical CIDP and CIDP variants in combined rituximab cohort than those in conventional therapy cohort, but had no differences between each other. Early initiating combined rituximab regimen (<10 weeks) showed better improvements than delayed initiation (≥10 weeks) at the first three visits within 28 weeks, while had no difference in favorable prognoses at the last visit of 52 weeks after once reinfusion. No rituximab correlated serious adverse events were reported in our patients.
Our simplified regimen of combined low-dose rituximab has been firstly demonstrated for the better efficacy and safety than conventional therapy in CIDP treatment.
确定低剂量利妥昔单抗联合传统疗法治疗慢性炎性脱髓鞘性多发性神经根神经病（CIDP）的疗效和安全性。
共纳入73例CIDP患者进行回顾性队列研究，分为传统一线治疗组（n = 40）和低剂量利妥昔单抗联合治疗组（每次输注100 mg，n = 33）。观察指标包括基线及定期随访4次（4、16、28和52周）时的I-RODS、mRS、INCAT、ONLS、TSS和COMPASS 31量表评分，以及良好反应和结局的比例、皮质类固醇剂量和随访期间病情恶化的发生率。
与传统治疗组相比，利妥昔单抗联合治疗组在每次随访的量表评估中均有更好的改善，良好反应比例更高，随访期间皮质类固醇剂量显著降低，病情恶化发生率降低。亚组分析显示，利妥昔单抗联合治疗组的典型CIDP和CIDP变异型患者的改善均优于传统治疗组，但两组之间无差异。在28周内的前三次随访中，早期开始利妥昔单抗联合治疗方案（<10周）的改善优于延迟开始（≥10周），而在单次再输注后52周的最后一次随访中，良好预后无差异。我们的患者中未报告与利妥昔单抗相关的严重不良事件。
我们首次证明，低剂量利妥昔单抗联合简化方案在CIDP治疗中比传统疗法具有更好的疗效和安全性。
