Article

Neuromyelitis optica (NMO) is a central nervous system inflammatory autoimmune
disease characterized by medullary and/or optical nerve damage. It is rare but
life-threatening. Concerning the treatment of NMO, many drugs have been used in
background therapy. Some studies have shown efficacy of rituximab (an antiCD20
monoclonal anti-body) either on the reduction of the annual number of
exacerbation or the mean score EDSS. In 2013, a Korean team reported a new
protocol during which they administered rituximab only when memory B lymphocytes
CD27+ were detectable in the bloodstream. In our patient, institution of this
protocol led to clinical benefit with a major decrease in the EDSS score over
time (7 in August 2012 vs. 1 in October 2015), a reduction of the total
administered dose (4g in 2013 vs. 1.375g in 2014 vs. 0g in 2015) and side
effects. Compared with the rate of theoretical administration, health expenditure
savings reached 1700 Euros per month over the 11-month treatment. Monitoring
therapeutic response markers with memory B lymphocyte counts appear to be an
efficient cost-effective way to measure clinical efficiency, reduce total doses, and limit side effects.
CI - Copyright (c) 2016. Published by Elsevier Masson SAS.

Langue : ANGLAIS