ArticleAnnals of clinical and translational neurology2025
Factors for Rituximab Refractoriness in AQP4-IgG+ NMOSD: A Cohort Study.
Article in Annals of clinical and translational neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Subsequent treatment strategies following rituximab-resistance in AQP4-IgG+ neuromyelitis optica spectrum disorder: a case series.Frontiers in immunology · 2026Article
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Authors and funding
9 authors.
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Abstract
objectiveNeuromyelitis optica spectrum disorder (NMOSD) is a severe autoimmune condition of the central nervous system (CNS), often associated with aquaporin-4 antibodies (AQP4-IgG). Rituximab, a CD20+ B-cell depleting monoclonal antibody, is widely used as first-line therapy. However, a subset of patients exhibits treatment refractoriness. Our objective is to investigate factors associated with treatment refractoriness in AQP4-IgG-positive NMOSD patients treated with rituximab.
methodsThis retrospective cohort study included 54 AQP4-IgG-positive NMOSD patients treated with rituximab between 2006 and 2023. Clinical, imaging, and genetic data were analyzed. Treatment failure was defined as at least one relapse occurring after 6 months of rituximab initiation. Statistical analyses included multivariate analyses of covariance (MANCOVA) and Cox regression to identify independent predictors of treatment failure.
resultsAmong the 54 patients (82.5% female, median age 45 years, range: 34-54.5), 12 (22.2%) exhibited rituximab treatment failure. The presence of asymptomatic lesions during follow-up was significantly associated with treatment failure (p = 0.02) and emerged as an independent predictor in MANCOVA (Wilks' Lambda = 0.01, F = 20.5, η
interpretationAsymptomatic lesions during rituximab treatment are a strong predictor of therapeutic failure in AQP4-IgG-positive NMOSD patients. Early identification of these lesions could guide clinicians in optimizing treatment strategies, including transitioning to alternative therapies.
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