Recommendations for the use of Rituximab in neuromyelitis optica spectrum disorders

Rev Neurol (Paris). 2018 Apr;174(4):255-264. doi: 10.1016/j.neurol.2017.11.005. Epub 2018 Mar 30.


There is growing evidence of a preventive effect of Rituximab (RTX) in neuromyelitis optica spectrum disorders (NMO-SD). This monoclonal antibody against CD20 is becoming the most widely used preventive therapy in NMO-SD, as a first-line therapy or as a rescue therapy. Nevertheless, considerable heterogeneity still exists concerning the pre-treatment work-up, the vaccinations required before and under treatment, the number and dosage of infusions, prevention of the risk of infusion-related reactions, prevention of infections under treatment, and frequency of therapeutic cycles. Thanks to a collaborative work among NMO-SD experts belonging to the NOMADMUS project, we provide here recommendations for all these topics concerning RTX use in NMO-SD.

Keywords: Guidelines; Neuromyelitis optica; Recommendations; Rituximab; Treatment.

Publication types

  • Practice Guideline
  • Review

MeSH terms

  • Antibodies, Monoclonal / therapeutic use
  • Humans
  • Neuromyelitis Optica / diagnosis
  • Neuromyelitis Optica / drug therapy*
  • Practice Guidelines as Topic
  • Rituximab / administration & dosage
  • Rituximab / therapeutic use*


  • Antibodies, Monoclonal
  • Rituximab