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A Review: The Use of Rituximab in Neuromuscular Diseases

Ibrahim, Homam MD*; Dimachkie, Mazen M MD, FAAN; Shaibani, Aziz MD, FACP, FAAN

Journal of Clinical Neuromuscular Disease: December 2010 - Volume 12 - Issue 2 - p 91-102
doi: 10.1097/CND.0b013e3181ff49f3
Review Article

Autoimmunity plays a major role in the pathogenesis of many neuromuscular disorders such as chronic inflammatory demyelinating polyneuropathy, Guillain-Barré syndrome, polymyositis, dermatomyositis, myasthenia gravis, Lambert Eaton syndrome, and stiff person syndrome. Although most of these disorders respond favorably to the commonly used immunomodulatory agents such as steroids, intravenous gamma globulin, plasmapheresis, and chemotherapy, some are initially refractory, whereas others gradually lose responsiveness. Therefore, alternative, selective, and novel immunosuppressive agents are used to treat these cases. Among these agents, rituximab has shown promise in some of the neuromuscular disorders with minimal side effects. Rituximab is a genetically engineered antibody that depletes CD20+ B-cells and is Food and Drug Administration- approved for treatment of non-Hodgkin lymphoma, CD20+ CLL, and rheumatoid arthritis. It carries a favorable side effects profile. However, evidence of efficacy is limited to case series and large prospective randomized controlled trials are lacking. In this article, we review and discuss the available literature on rituximab in treatment of various autoimmune neuromuscular diseases.

From *The Methodist Hospital, Houston, TX; the †University of Kansas Medical Center, Kansas City, KS; and ‡The Nerve and Muscle Center of Texas, Houston, TX.

Reprints: Aziz Shaibani, MD, FACP, FAAN, The Nerve and Muscle Center of Texas, 6624 Fannin st. #1670, Houston, TX 77030 (e-mail:

© 2010 Lippincott Williams & Wilkins, Inc.