Rituximab in patients with pediatric multiple sclerosis and other demyelinating disorders of the CNS: Practical considerations

Angelo Ghezzi; Brenda Banwell; Amit Bar-Or; Tanuja Chitnis; Russell C Dale; Mark Gorman; Barbara Kornek; Lauren Krupp; Kristen M Krysko; Margherita Nosadini; Kevin Rostasy; Jonatan Salzer; Teri Schreiner; Silvia Tenembaum; Emmanuelle Waubant

doi:10.1177/1352458520932798

Rituximab in patients with pediatric multiple sclerosis and other demyelinating disorders of the CNS: Practical considerations

Mult Scler. 2021 Oct;27(12):1814-1822. doi: 10.1177/1352458520932798. Epub 2020 Jun 19.

Authors

Affiliations

¹ Centro Studi Sclerosi Multipla, Ospedale di Gallarate, ASST Valleolona, Gallarate, Italy.
² Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
³ Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA/Center for Neuroinflammation and Experimental Therapeutics and the Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
⁴ Partners Pediatric MS Center, Massachusetts General Hospital, Boston, MA, USA.
⁵ Kids Neuroscience Centre and Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
⁶ Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
⁷ Department of Neurology, Medical University of Vienna, Vienna, Austria.
⁸ Multiple Sclerosis Comprehensive Care Center, Department of Neurology, NYU Langone Health, New York, NY, USA.
⁹ UCSF Weill Institute for Neurosciences, Department of Neurology, University of California San Francisco, San Francisco, CA, USA.
¹⁰ Pediatric Neurology and Neurophysiology Unit, Department of Women's and Children's Health, University Hospital of Padua, Padua, Italy.
¹¹ Department of Pediatric Neurology, Children's Hospital Datteln, University Witten/Herdecke, Witten, Germany.
¹² Department of Clinical Science, Neurosciences, Umeå University, Umeå, Sweden.
¹³ Children's Hospital Colorado, University of Colorado, Aurora, CO, USA.
¹⁴ Pediatric Neuroimmunology Program, Department of Neurology, National Pediatric Hospital Dr. Juan P. Garrahan, Buenos Aires, Argentina.
¹⁵ UCSF Pediatric MS Clinic and UCSF Adult MS Clinic, Department of Neurology, University of California at San Francisco, San Francisco CA, USA.

PMID: 32552353
DOI: 10.1177/1352458520932798

Abstract

Anti-CD20 therapies have established efficacy in the treatment of immune-mediated neurological and non-neurological diseases. Rituximab, one of the first B-cell-directed therapies, is relatively inexpensive compared to newer anti-CD20 molecules, is available in many countries, and has been used off-label in pediatric patients with neuroimmune conditions. The objective of this paper is to describe the experience with rituximab in pediatric multiple sclerosis and other inflammatory immune-mediated disorders of the central nervous system (CNS), and to define a protocol for its use in clinical practice, in particular addressing doses, interval of administration, duration of treatment, and tests to perform at baseline and during follow-up.

Keywords: CD19+ cells; CD20+ cells; Pediatric multiple sclerosis; anti-CD20 therapy; rituximab.

Publication types

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

MeSH terms

Antigens, CD20
Central Nervous System
Child
Humans
Multiple Sclerosis* / drug therapy
Rituximab / therapeutic use

Substances

Antigens, CD20
Rituximab