Evidence map›Paper›PMID 34079936›Full record

ArticleBMJ neurology open2021

Bortezomib for anti-NMDAR encephalitis following daclizumab treatment in a patient with multiple sclerosis.

Kushan Karunaratne, Dariush Ahrabian, Bernadette Monoghan, Tom Campion, Tarek Yousry, Michael P Lunn, Michael S Zandi, Robin S Howard, Dimitri M Kullmann, Jennifer Spillane and 2 more

Erratum issuedOpen access · diamondAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ neurology open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
0.9field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.

  1. Clinical Characteristics of Anti-Frontiers in immunology · 2022
    Pooled it
  2. Autoimmune encephalitis.Nature reviews. Disease primers · 2025
    Review
  3. Glucocorticoid-dependent multiple sclerosis overlapping anti-NMDA receptor encephalitis: a case report and literature review update.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2024
    Review
  4. Review
  5. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors at 2 institutions in 1 country.

Kushan KarunaratneNational Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK.ORCID 0000-0002-2876-9028
Dariush AhrabianNational Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK.
Bernadette MonoghanNational Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK.
Tom CampionLysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, University College London Hospitals NHS Foundation Trust National Hospital for Neurology and Neurosurgery, London, UK.
Tarek YousryLysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, University College London Hospitals NHS Foundation Trust National Hospital for Neurology and Neurosurgery, London, UK.
Michael P LunnMRC Centre for Neuromuscular Disease and Department of Molecular Neuroscience, University College London Hospitals NHS Foundation Trust National Hospital for Neurology and Neurosurgery, London, UK.ORCID 0000-0003-3174-6027
Michael S ZandiNational Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK.
Robin S HowardNational Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK.
Dimitri M KullmannNational Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK.
Jennifer SpillaneNational Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK.
Matthew WalkerDepartment of Clinical and Experimental Epilepsy, UCL Institute of Neurology, University College London Hospitals NHS Foundation Trust National Hospital for Neurology and Neurosurgery, London, UK.
Jeremy ChatawayNIHR Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London, UK.
University College London Hospitals NHS Foundation Trust · GBQueen Mary University of London · GB

Funding

Medical Research Council MR/M009106/1Wellcome Trust 212285/Z/18/Z
6 · The paper itself

Abstract

backgroundDaclizumab is an anti-CD25 monoclonal antibody developed for the treatment of relapsing remitting multiple sclerosis, which was withdrawn worldwide in March 2018, due to emerging serious immune-mediated systemic andcentral nervous system adverse events. We report a case of anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis occurring 14 weeks after stopping daclizumab, which responded to the proteasome inhibitor bortezomib.

methodsFollowing lack of effective clinical response to first line (corticosteroid, plasma exchange, intravenous immunoglobulin) and second line (rituximab) treatments, bortezomib therapy was commenced. The patient received six cycles of bortezomib treatment.

resultsClinical improvement was noted 4 weeks after the first of six cycles of bortezomib and the patient experienced sustained clinical improvement.

conclusionOur case provides further class IV evidence of the use of bortezomib therapy for treatment refractory anti-NMDAR encephalitis.

Indexed as

multiple sclerosisNMDA

Identifiers

PMID34079936
PMCPMC8137234
OpenAlexW3162752750

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.