Efficacy of rituximab in refractory neuromyelitis optica

Mult Scler. 2016 Jun;22(7):955-9. doi: 10.1177/1352458515602337. Epub 2015 Sep 11.


Background: Despite a growing use of rituximab (RTX) in neuromyelitis optica (NMO), data are lacking in patients with refractory NMO (RNMO), defined as cases with at least one relapse during immunosuppressive therapy.

Objective: The purpose of this study was to assess RTX as a maintenance therapy in RNMO.

Methods: Out of a total of 305 NMO cases from a population-based cohort, 21 RNMO patients received RTX during a mean follow-up period of 31 months.

Results: After RTX, 11 patients (52.3%) were relapse free, meaning that 47.7% were refractory to RTX. The mean annualized relapse rate decreased from 1.3 to 0.4 (p<0.001) and median EDSS from 5 to 3 (p=0.02). Body mass index (BMI) was predictive of EDSS worsening.

Conclusions: RTX is an effective and well-tolerated treatment in RNMO. BMI could be a predictive factor for efficacy.

Keywords: Neuromyelitis optica; body mass index; disability; refractory; rituximab.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Body Mass Index
  • Disability Evaluation
  • Disease Progression
  • Female
  • Humans
  • Immunosuppressive Agents / adverse effects
  • Immunosuppressive Agents / therapeutic use*
  • Male
  • Middle Aged
  • Neuromyelitis Optica / diagnosis
  • Neuromyelitis Optica / drug therapy*
  • Neuromyelitis Optica / immunology
  • Recurrence
  • Remission Induction
  • Risk Factors
  • Rituximab / adverse effects
  • Rituximab / therapeutic use*
  • Time Factors
  • Treatment Outcome
  • Young Adult


  • Immunosuppressive Agents
  • Rituximab