Rituximab in patients with pediatric multiple sclerosis and other demyelinating disorders of the CNS: Practical considerations
Angelo Ghezzi, Brenda Banwell, Amit Bar‐Or, Tanuja Chitnis, Russell C. Dale, Mark Gorman, Barbara Kornek, Lauren Krupp, Kristen M. Krysko, Margherita Nosadini, Kevin Rostásy, Jonatan Salzer, Teri Schreiner, Sílvia Tenembaum, Emmanuelle Waubant
Abstract
Anti-CD20 therapies have established efficacy in the treatment of immune-mediated neurological and non-neurological diseases. Rituximab, one of the first B-cell-directed therapies, is relatively inexpensive compared to newer anti-CD20 molecules, is available in many countries, and has been used off-label in pediatric patients with neuroimmune conditions. The objective of this paper is to describe the experience with rituximab in pediatric multiple sclerosis and other inflammatory immune-mediated disorders of the central nervous system (CNS), and to define a protocol for its use in clinical practice, in particular addressing doses, interval of administration, duration of treatment, and tests to perform at baseline and during follow-up.