ETD

• anti-MAG neuropathy
• autoimmune nodopathies
• chronic immune-mediated neuropathies
• CIDP
• electroneurography
• elettroneurografia
• neuropatia anti-MAG
• neuropatie disimmuni croniche
• nodopatie autoimmuni
• Rituximab

Chronic immune-mediated neuropathies, such as CIDP, MMN, anti-MAG neuropathy, and autoimmune nodopathies, are heterogeneous disorders characterized by immune-mediated activity against the peripheral nerve. Rituximab, an anti-CD20 monoclonal antibody, has proven effective due to the depletion of CD20-positive B cells.
This retrospective study analyzed the efficacy of Rituximab in immune-mediated neuropathies at the Neurology Hospital-University Unit of Pisa Hospital. Primary outcomes included changes in clinical scales (INCAT, MRC-SS) and electroneurographic parameters one year after therapy.
Thirteen patients were included, of whom seven were positive for specific antibodies (five anti-MAG, two anti-node/paranode) and eight had hematological comorbidities (MW, IgM MGUS). One year after Rituximab, the INCAT score improved from 4.0±2.3 to 2.0±1.5 (p=0.005) and the MRC-SS scale increased from 53.2±11.9 to 57.4±11.4 (p=0.046). Electrophysiologically, there was a significant improvement in distal latency (-0.398, p=0.013) and amplitude (+0.331, p=0.014). Disease duration showed an inverse correlation with INCAT variation (Rho -0.593, p=0.033). Seropositive patients had better outcome than seronegative.
Rituximab has proven effective in chronic immune-mediated neuropathies with significant clinical and neurophysiological improvements. Our data highlight the importance of timely treatment and the study of individual immunological factors.