Details

Autor(en) / Beteiligte

• Zabala‐Ángeles, Indhira
• García‐Estrada, Christian
• Gómez‐Figueroa, Enrique
• Rodriguez‐Rivas, Roberto
• Higuera‐Gonzalez, Edgar
• Casallas‐Vanegas, Adriana
• Aguirre‐Cruz, Lucinda
• Corona‐Vázquez, Teresa
• Flores‐Rivera, José
• Rivas‐Alonso, Verónica

Titel

Anti‐aquaporin‐4 positive‐to‐negative seroconversion in Latin American patients with neuromyelitis optica spectrum disorder treated with rituximab

Ist Teil von

• Clinical & experimental neuroimmunology, 2021-11, Vol.12 (4), p.248-252

Ort / Verlag

Ube: Wiley Subscription Services, Inc

Erscheinungsjahr

2021

Quelle

Wiley Online Library Journals Frontfile Complete

Beschreibungen/Notizen

• Objective Rituximab (RTX) is a monoclonal antibody directed against CD20 epitope expressed on B cells used widely in neuromyelitis optica spectrum disorder (NMOsd). There are few studies evaluating anti‐aquaporin‐4 (AQP4) positive‐to‐negative seroconversion. In this series, we evaluated this phenomenon in a Latin American population. Methods A retrospective, longitudinal and analytic study was carried out in 19 AQP4 immunoglobulin G (IgG)+ NMOsd patients. We monitored all patients with a yearly test for AQP4‐IgG serum autoantibodies. Potential relationships between negative seroconversion and annualized relapse rate, Expanded Disability Status Scale score, immunosuppressive or immunoregulatory treatment were assessed. Results We included 19 patients, 17 (89.5%) were women. The mean Expanded Disability Status Scale score and annualized relapse rate at clinical onset was 3.8 (±1.97) and 0.81 (±0.577), respectively. Disease‐modifying treatment included RTX, cyclophosphamide, azathioprine and methotrexate. We documented positive‐to‐negative seroconversion in six of the patients in the RTX group (P = 0.047). No significant changes were observed in the annualized relapse rate (2.11 vs 1.88, P = 0.06) or Expanded Disability Status Scale scores (4.41 vs 3.1, P = 0.25) between the group of seroconverted patients from those who remained positive. Conclusions Treatment with RTX in patients with seropositive AQP4‐IgG NMOsd can lead to negative conversion, but our findings do not support a clinical reflection from this change. The role of monitoring for AQP4‐IgG is yet to be defined in the Mexican NMOsd population. Rituximab treatment in Latin American neuromyelitis optica spectrum disorder patients is associated with positive‐to‐negative aquaporin‐4 seroconversion.