Use of Monoclonal Antibodies in Neurology in Riga East University Hospital General Neurology Department

Activity: Talk or presentation types › Oral presentation

Description

Introduction. Rituximab, ocrelizumab and ofatumumab are chimeric monoclonal antibodies that selectively deplete CD20+ B-cells. Regarding neurological diseases, these agents are reserved as second or last line treatment with rituximab not included in any standardized treatment protocols. Studies have shown favorable outcomes in treatment of multiple neurological diseases.Aim. To analyze the indications, treatment regimen, side effects, efficacy and outcome of monoclonal antibody usage in neurological diseases in the Riga East University Hospital, department of General Neurology. . In this retrospective study data were collected from the medical cards of 55 patients treated with monoclonal antibodies from January 2018 to December 2022. . Thirteen patients received ocrelizumab, 25 patients received ofatumumab, 17 patients received rituximab, with diagnosis of multiple sclerosis (40 patients), autoimmune encephalitis (5 patients), chronic autoimmune demyelinating polyneuropathy (4 patients), cerebral vasculitis (2 patients), myasthenia gravis (1 patient), idiopathic hypertrophic pachymeningitis (1 patient), MOG antibody associated disease (1 patient) and Erdheim-Chester disease (1 patient).In all cases ocrelizumab 600 mg and rituximab 1000 mg were administered intravenously, ranging from 1 dose to continuous doses every 6 months. Ofatumumab 20 mg was administered subcutaneously every month. All patients received premedication before ocrelizumab and rituximab. In one case ocrelizumab was stopped due to allergic reaction, no other significant side effects were documented. In 5 cases of aggressive multiple sclerosis ofatumumab was started as a first line immunomodulatory therapy, in all other cases monoclonal antibodies were administered after first line treatment failed.Symptom control was achieved in all chronic disease cases, eminent improvement was documented in four autoimmune encephalitis cases of rituximab therapy, and only one case marked no improvement after repeated doses of monoclonal antibody treatment.. Monoclonal antibodies are safely and effectively used in the treatment of neurological diseases, however further research is necessary in this line of treatment.
Period29 Mar 2023
Event titleRSU International Research Conference 2023: Knowledge for Use in Practice
Event typeConference
OrganiserRīga Stradiņš University
LocationRiga, LatviaShow on map
Degree of RecognitionInternational

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