ALSUntangled #67: rituximab

Xiaoyan Li; Carmel Armon; Paul Barkhaus; Benjamin Barnes; Michael Benatar; Tulio Bertorini; Mark Bromberg; Gregory T Carter; Jesse Crayle; Merit Cudkowicz; Mazen Dimachkie; Eva L Feldman; Jonathan Glass; Jill Goslinga; Terry Heiman-Patterson; Sartaj Jhooty; Rachel Lichtenstein; Isaac Lund; Christopher Mcdermott; Gary Pattee; Kaitlyn Pierce; Dylan Ratner; Kristiana Salmon; Paul Wicks; Richard Bedlack

doi:10.1080/21678421.2022.2122845

ALSUntangled #67: rituximab

Amyotroph Lateral Scler Frontotemporal Degener. 2023 Aug;24(5-6):544-547. doi: 10.1080/21678421.2022.2122845. Epub 2022 Sep 15.

Authors

Xiaoyan Li¹, Carmel Armon², Paul Barkhaus³, Benjamin Barnes⁴, Michael Benatar⁵, Tulio Bertorini⁶, Mark Bromberg⁷, Gregory T Carter⁸, Jesse Crayle⁹, Merit Cudkowicz¹⁰, Mazen Dimachkie¹¹, Eva L Feldman¹², Jonathan Glass¹³, Jill Goslinga¹⁴, Terry Heiman-Patterson¹⁵, Sartaj Jhooty¹⁶, Rachel Lichtenstein¹⁷, Isaac Lund¹⁸, Christopher Mcdermott¹⁹, Gary Pattee²⁰, Kaitlyn Pierce²¹, Dylan Ratner²², Kristiana Salmon²³, Paul Wicks²⁴, Richard Bedlack¹

Affiliations

¹ Department of Neurology, Duke University, Durham, NC, USA.
² Department of Neurology, Loma Linda University, Loma Linda, CA, USA.
³ Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA.
⁴ Department of Neurology, Medical College of Georgia, Augusta, GA, USA.
⁵ Department of Neurology, University of Miami, Miami, FL, USA.
⁶ Neurology Department, University of Tennessee Health Science Center, Memphis, TN, USA.
⁷ Department of Neurology, University of Utah, Salt Lake City, UT, USA.
⁸ Department of Rehabilitation, Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA.
⁹ Neurology Department, Washington University, St. Louis, MO, USA.
¹⁰ Department of Neurology, Harvard Medical School, Boston, MA, USA.
¹¹ Department of Neurology, University of Kansas, Kansas City, KS, USA.
¹² Department of Neurology, University of Michigan, Ann Arbor, MI, USA.
¹³ Department of Neurology, Emory University, Atlanta, GA, USA.
¹⁴ Department of Neurology, University of California San Francisco, San Francisco, CA, USA.
¹⁵ Department of Neurology, Temple Health, Philadelphia, PA, USA.
¹⁶ University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
¹⁷ Avram and Stella Goren-Goldstein Biotechnology Engineering Department, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
¹⁸ Undergraduate, Green Hope High School, Cary, NC, USA.
¹⁹ Department of Neuroscience, University of Sheffield, Sheffield, UK.
²⁰ Department of Neurology, University of Nebraska Medical Center, Omaha, NE, USA.
²¹ Department of Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
²² Undergraduate, Longmeadow High School, Longmeadow, MA, USA.
²³ Department of Neurology, Montreal Neurological Institute, Montreal, CA and.
²⁴ Independent Consultant, Lichfield, UK.

PMID: 36106861
DOI: 10.1080/21678421.2022.2122845

Abstract

ALSUntangled reviews alternative and off-label treatments on behalf of people with ALS who ask about them. Here we review rituximab, a drug which specifically depletes B lymphocytes. We show a current lack of evidence for a role of these cells in ALS progression. The one patient we found who described using Rituximab for their ALS found no benefit. Given all this, and the known serious risks of rituximab, we advise against its use as an ALS treatment.

Keywords: ALS; neuroinflammation; off-label treatment; rituximab.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Amyotrophic Lateral Sclerosis* / drug therapy
Humans
Off-Label Use
Rituximab* / therapeutic use

Substances

Rituximab