Rituximab for the treatment of thymoma-associated and de novo myasthenia gravis: 3 cases and review

Robert Nelson, Robert Pascuzzi, Kenneth Kesler, Larry Walsh, Phillip P. Faught, Srinivasan Ramanuja, Mark D. Pescovitz, Patrick Loehrer

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

OBJECTIVES:: Myasthenia gravis (MG) is an immune-mediated disorder associated with autoantibodies against postsynaptic nicotinic acetylcholine receptors at neuromuscular junctions. Rituximab, a monoclonal antibody specific for CD20, is used primarily to treat B-cell non-Hodgkin lymphoma. Although it has been used for treatment of a number of autoimmune diseases, there is limited experience in MG. METHODS:: Three patients with refractory MG (2 with concurrent thymoma) were given rituximab. RESULTS:: Symptoms stabilized and reductions in immunosuppressive medications were tolerated for extended periods, without adverse effects or infectious complications. CONCLUSIONS:: These observations support the concept that rituximab may be helpful for the treatment of MG. Remissions in patients with or without thymoma are achievable with rituximab given in combination with commonly used modalities. Furthermore, rituximab is not necessarily contraindicated for the treatment of MG in patients being treated for thymoma. Controlled studies are called for to define its role in the treatment of refractory MG.

Original languageEnglish
Pages (from-to)170-177
Number of pages8
JournalJournal of Clinical Neuromuscular Disease
Volume10
Issue number4
DOIs
StatePublished - Jun 2009

Fingerprint

Thymoma
Myasthenia Gravis
Therapeutics
Neuromuscular Junction
Immune System Diseases
Nicotinic Receptors
B-Cell Lymphoma
Immunosuppressive Agents
Autoantibodies
Non-Hodgkin's Lymphoma
Autoimmune Diseases
Rituximab
Monoclonal Antibodies

Keywords

  • Immunomodulation
  • Myasthenia gravis
  • Neuroimmunology
  • Rituximab

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

Cite this

Rituximab for the treatment of thymoma-associated and de novo myasthenia gravis : 3 cases and review. / Nelson, Robert; Pascuzzi, Robert; Kesler, Kenneth; Walsh, Larry; Faught, Phillip P.; Ramanuja, Srinivasan; Pescovitz, Mark D.; Loehrer, Patrick.

In: Journal of Clinical Neuromuscular Disease, Vol. 10, No. 4, 06.2009, p. 170-177.

Research output: Contribution to journalArticle

@article{d3d5940436d945ecaf13136e25077da8,
title = "Rituximab for the treatment of thymoma-associated and de novo myasthenia gravis: 3 cases and review",
abstract = "OBJECTIVES:: Myasthenia gravis (MG) is an immune-mediated disorder associated with autoantibodies against postsynaptic nicotinic acetylcholine receptors at neuromuscular junctions. Rituximab, a monoclonal antibody specific for CD20, is used primarily to treat B-cell non-Hodgkin lymphoma. Although it has been used for treatment of a number of autoimmune diseases, there is limited experience in MG. METHODS:: Three patients with refractory MG (2 with concurrent thymoma) were given rituximab. RESULTS:: Symptoms stabilized and reductions in immunosuppressive medications were tolerated for extended periods, without adverse effects or infectious complications. CONCLUSIONS:: These observations support the concept that rituximab may be helpful for the treatment of MG. Remissions in patients with or without thymoma are achievable with rituximab given in combination with commonly used modalities. Furthermore, rituximab is not necessarily contraindicated for the treatment of MG in patients being treated for thymoma. Controlled studies are called for to define its role in the treatment of refractory MG.",
keywords = "Immunomodulation, Myasthenia gravis, Neuroimmunology, Rituximab",
author = "Robert Nelson and Robert Pascuzzi and Kenneth Kesler and Larry Walsh and Faught, {Phillip P.} and Srinivasan Ramanuja and Pescovitz, {Mark D.} and Patrick Loehrer",
year = "2009",
month = "6",
doi = "10.1097/CND.0b013e31819a8403",
language = "English",
volume = "10",
pages = "170--177",
journal = "Journal of Clinical Neuromuscular Disease",
issn = "1522-0443",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

TY - JOUR

T1 - Rituximab for the treatment of thymoma-associated and de novo myasthenia gravis

T2 - 3 cases and review

AU - Nelson, Robert

AU - Pascuzzi, Robert

AU - Kesler, Kenneth

AU - Walsh, Larry

AU - Faught, Phillip P.

AU - Ramanuja, Srinivasan

AU - Pescovitz, Mark D.

AU - Loehrer, Patrick

PY - 2009/6

Y1 - 2009/6

N2 - OBJECTIVES:: Myasthenia gravis (MG) is an immune-mediated disorder associated with autoantibodies against postsynaptic nicotinic acetylcholine receptors at neuromuscular junctions. Rituximab, a monoclonal antibody specific for CD20, is used primarily to treat B-cell non-Hodgkin lymphoma. Although it has been used for treatment of a number of autoimmune diseases, there is limited experience in MG. METHODS:: Three patients with refractory MG (2 with concurrent thymoma) were given rituximab. RESULTS:: Symptoms stabilized and reductions in immunosuppressive medications were tolerated for extended periods, without adverse effects or infectious complications. CONCLUSIONS:: These observations support the concept that rituximab may be helpful for the treatment of MG. Remissions in patients with or without thymoma are achievable with rituximab given in combination with commonly used modalities. Furthermore, rituximab is not necessarily contraindicated for the treatment of MG in patients being treated for thymoma. Controlled studies are called for to define its role in the treatment of refractory MG.

AB - OBJECTIVES:: Myasthenia gravis (MG) is an immune-mediated disorder associated with autoantibodies against postsynaptic nicotinic acetylcholine receptors at neuromuscular junctions. Rituximab, a monoclonal antibody specific for CD20, is used primarily to treat B-cell non-Hodgkin lymphoma. Although it has been used for treatment of a number of autoimmune diseases, there is limited experience in MG. METHODS:: Three patients with refractory MG (2 with concurrent thymoma) were given rituximab. RESULTS:: Symptoms stabilized and reductions in immunosuppressive medications were tolerated for extended periods, without adverse effects or infectious complications. CONCLUSIONS:: These observations support the concept that rituximab may be helpful for the treatment of MG. Remissions in patients with or without thymoma are achievable with rituximab given in combination with commonly used modalities. Furthermore, rituximab is not necessarily contraindicated for the treatment of MG in patients being treated for thymoma. Controlled studies are called for to define its role in the treatment of refractory MG.

KW - Immunomodulation

KW - Myasthenia gravis

KW - Neuroimmunology

KW - Rituximab

UR - http://www.scopus.com/inward/record.url?scp=68549085230&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=68549085230&partnerID=8YFLogxK

U2 - 10.1097/CND.0b013e31819a8403

DO - 10.1097/CND.0b013e31819a8403

M3 - Article

C2 - 19494727

AN - SCOPUS:68549085230

VL - 10

SP - 170

EP - 177

JO - Journal of Clinical Neuromuscular Disease

JF - Journal of Clinical Neuromuscular Disease

SN - 1522-0443

IS - 4

ER -