B cell depletion can be effective in multiple sclerosis but failed in a patient with advanced childhood cerebral X-linked adrenoleukodystrophy

Rituximab exerts its clinical efficacy by its specific pattern of depletion of CD20 + B lymphocytes and it has been demonstrated that rituximab is an effective treatment for relapsing remitting multiple sclerosis. X-linked adrenoleukodystrophy (X-ALD), the most common monogenetic neuroinflammatory d...

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Bibliographic Details
Main Authors: Hendrik Rosewich, Stefan Nessler, Wolfgang Brück, Jutta Gärtner
Format: Article
Language:English
Published: SAGE Publishing 2019-08-01
Series:Therapeutic Advances in Neurological Disorders
Online Access:https://doi.org/10.1177/1756286419868133
Description
Summary:Rituximab exerts its clinical efficacy by its specific pattern of depletion of CD20 + B lymphocytes and it has been demonstrated that rituximab is an effective treatment for relapsing remitting multiple sclerosis. X-linked adrenoleukodystrophy (X-ALD), the most common monogenetic neuroinflammatory disorder, shares substantial overlap with multiple sclerosis in the neuropathological changes found in brain tissues in advanced stages of the disease. While there is no effective therapy for these patients, we hypothesized that rituximab might be effective in arresting the neuroinflammatory process. Our detailed clinical, imaging and immunological data revealed that rituximab is not effective in advanced stages of X-ALD and consequently should not be applied for compassionate use in these patients.
ISSN:1756-2864