PMID- 37290967
OWN - NLM
STAT- MEDLINE
DCOM- 20230726
LR  - 20230819
IS  - 1526-632X (Electronic)
IS  - 0028-3878 (Print)
IS  - 0028-3878 (Linking)
VI  - 101
IP  - 4
DP  - 2023 Jul 25
TI  - Rituximab De-escalation in Patients With Neuromyelitis Optica Spectrum Disorder.
PG  - e438-e450
LID - 10.1212/WNL.0000000000207443 [doi]
AB  - BACKGROUND AND OBJECTIVES: Exit strategies such as de-escalations have not been 
      evaluated for rituximab in patients with neuromyelitis optica spectrum disorder 
      (NMOSD). We hypothesized that they are associated with disease reactivations and 
      aimed to estimate this risk. METHODS: We describe a case series of real-world 
      de-escalations from the French NMOSD registry (NOMADMUS). All patients met the 
      2015 International Panel for NMO Diagnosis (IPND) diagnostic criteria for NMOSD. 
      A computerized screening of the registry extracted patients with rituximab 
      de-escalations and at least 12 months of subsequent follow-up. We searched for 7 
      de-escalation regimens: scheduled discontinuations or switches to an oral 
      treatment after single infusion cycles, scheduled discontinuations or switches to 
      an oral treatment after periodic infusions, de-escalations before pregnancies, 
      de-escalations after tolerance issues, and increased infusion intervals. 
      Rituximab discontinuations motivated by inefficacy or for unknown purposes were 
      excluded. The primary outcome was the absolute risk of NMOSD reactivation (one or 
      more relapses) at 12 months. AQP4+ and AQP4- serotypes were analyzed separately. 
      RESULTS: We identified 137 rituximab de-escalations between 2006 and 2019 that 
      corresponded to a predefined group: 13 discontinuations after a single infusion 
      cycle, 6 switches to an oral treatment after a single infusion cycle, 9 
      discontinuations after periodic infusions, 5 switches to an oral treatment after 
      periodic infusions, 4 de-escalations before pregnancies, 9 de-escalations after 
      tolerance issues, and 91 increased infusion intervals. No group remained 
      relapse-free over the whole de-escalation follow-up (mean: 3.2 years; range: 
      0.79-9.5), except pregnancies in AQP+ patients. In all groups combined and within 
      12 months, reactivations occurred after 11/119 de-escalations in patients with 
      AQP4+ NMOSD (9.2%, 95% CI [4.7-15.9]), from 0.69 to 10.0 months, and in 5/18 
      de-escalations in patients with AQP4- NMOSD (27.8%, 95% CI [9.7-53.5]), from 1.1 
      to 9.9 months. DISCUSSION: There is a risk of NMOSD reactivation whatever the 
      rituximab de-escalation regimen. TRIAL REGISTRATION INFORMATION: Registered on 
      ClinicalTrials.gov: NCT02850705. CLASSIFICATION OF EVIDENCE: This study provides 
      Class IV evidence that de-escalation of rituximab increases the probability of 
      disease reactivation.
CI  - (c) 2023 American Academy of Neurology.
FAU - Demuth, Stanislas
AU  - Demuth S
AUID- ORCID: 0000-0002-2504-5294
AD  - From the Department of Neurology (S.D., N.C., J.D.S.); Clinical Investigation 
      Center (N.C., J.D.S.), Strasbourg University Hospital; Department of Neurology 
      (B.A.), APHM, Hopital de la Timone, Pole de Neurosciences Cliniques, Marseille; 
      Department of Neurology (X.A.), Montpellier University Hospital; Department of 
      Neurology (B.B.), Rouen University Hospital; Department of Neurology CRC-SEP 
      (J.C.), CHU Toulouse; Department of Neurology, CHU Poitiers (J.C.); Department of 
      Neurology (M.C.), CHU de Nice, UR2CA-URRIS, Nice Cote d'Azur University; 
      Department of Neurology (R.D.), Hopital Fondation Adolphe de Rothschild, Paris; 
      Department of Neurology (F.D.U.R.A.N.D.-D.U.B.I.E.F.), Sclerose en Plaques, 
      Pathologies de la Myeline et Neuro-inflammation, Hopital Neurologique, Hospices 
      Civils de Lyon; Department of Neurology (E.M., C.P.), AP-HP, Pitie-Salpetriere 
      Hospital, Paris; Department of Neurology (Groupe Hospitalier Pellegrin) (A.R.), 
      Centre Hospitalier Universitaire de Bordeaux; Universite de Bordeaux (A.R.), 
      INSERM U1215, Neurocentre Magendie; Department of Neurology (H.Z.), University 
      Hospital of Lille, UFR3S Univ-Lille, Inserm U 1172; Service de Neurologie, 
      Sclerose en Plaques, Pathologies de la Myeline et Neuro Inflammation (R.M.), and 
      Centre de Reference des Maladies Inflammatoires Rares du Cerveau et de la Moelle 
      (MIRCEM), Hopital Neurologique Pierre Wertheimer, Bron; Centre des Neurosciences 
      de Lyon-FORGETTING Team (R.M.), INSERM 1028 and CNRS UMR5292; and Universite 
      Claude Bernard Lyon 1 (R.M.), France.
FAU - Collongues, Nicolas
AU  - Collongues N
AUID- ORCID: 0000-0002-3683-5582
AD  - From the Department of Neurology (S.D., N.C., J.D.S.); Clinical Investigation 
      Center (N.C., J.D.S.), Strasbourg University Hospital; Department of Neurology 
      (B.A.), APHM, Hopital de la Timone, Pole de Neurosciences Cliniques, Marseille; 
      Department of Neurology (X.A.), Montpellier University Hospital; Department of 
      Neurology (B.B.), Rouen University Hospital; Department of Neurology CRC-SEP 
      (J.C.), CHU Toulouse; Department of Neurology, CHU Poitiers (J.C.); Department of 
      Neurology (M.C.), CHU de Nice, UR2CA-URRIS, Nice Cote d'Azur University; 
      Department of Neurology (R.D.), Hopital Fondation Adolphe de Rothschild, Paris; 
      Department of Neurology (F.D.U.R.A.N.D.-D.U.B.I.E.F.), Sclerose en Plaques, 
      Pathologies de la Myeline et Neuro-inflammation, Hopital Neurologique, Hospices 
      Civils de Lyon; Department of Neurology (E.M., C.P.), AP-HP, Pitie-Salpetriere 
      Hospital, Paris; Department of Neurology (Groupe Hospitalier Pellegrin) (A.R.), 
      Centre Hospitalier Universitaire de Bordeaux; Universite de Bordeaux (A.R.), 
      INSERM U1215, Neurocentre Magendie; Department of Neurology (H.Z.), University 
      Hospital of Lille, UFR3S Univ-Lille, Inserm U 1172; Service de Neurologie, 
      Sclerose en Plaques, Pathologies de la Myeline et Neuro Inflammation (R.M.), and 
      Centre de Reference des Maladies Inflammatoires Rares du Cerveau et de la Moelle 
      (MIRCEM), Hopital Neurologique Pierre Wertheimer, Bron; Centre des Neurosciences 
      de Lyon-FORGETTING Team (R.M.), INSERM 1028 and CNRS UMR5292; and Universite 
      Claude Bernard Lyon 1 (R.M.), France.
FAU - Audoin, Bertrand
AU  - Audoin B
AUID- ORCID: 0000-0002-9860-7657
AD  - From the Department of Neurology (S.D., N.C., J.D.S.); Clinical Investigation 
      Center (N.C., J.D.S.), Strasbourg University Hospital; Department of Neurology 
      (B.A.), APHM, Hopital de la Timone, Pole de Neurosciences Cliniques, Marseille; 
      Department of Neurology (X.A.), Montpellier University Hospital; Department of 
      Neurology (B.B.), Rouen University Hospital; Department of Neurology CRC-SEP 
      (J.C.), CHU Toulouse; Department of Neurology, CHU Poitiers (J.C.); Department of 
      Neurology (M.C.), CHU de Nice, UR2CA-URRIS, Nice Cote d'Azur University; 
      Department of Neurology (R.D.), Hopital Fondation Adolphe de Rothschild, Paris; 
      Department of Neurology (F.D.U.R.A.N.D.-D.U.B.I.E.F.), Sclerose en Plaques, 
      Pathologies de la Myeline et Neuro-inflammation, Hopital Neurologique, Hospices 
      Civils de Lyon; Department of Neurology (E.M., C.P.), AP-HP, Pitie-Salpetriere 
      Hospital, Paris; Department of Neurology (Groupe Hospitalier Pellegrin) (A.R.), 
      Centre Hospitalier Universitaire de Bordeaux; Universite de Bordeaux (A.R.), 
      INSERM U1215, Neurocentre Magendie; Department of Neurology (H.Z.), University 
      Hospital of Lille, UFR3S Univ-Lille, Inserm U 1172; Service de Neurologie, 
      Sclerose en Plaques, Pathologies de la Myeline et Neuro Inflammation (R.M.), and 
      Centre de Reference des Maladies Inflammatoires Rares du Cerveau et de la Moelle 
      (MIRCEM), Hopital Neurologique Pierre Wertheimer, Bron; Centre des Neurosciences 
      de Lyon-FORGETTING Team (R.M.), INSERM 1028 and CNRS UMR5292; and Universite 
      Claude Bernard Lyon 1 (R.M.), France.
FAU - Ayrignac, Xavier
AU  - Ayrignac X
AUID- ORCID: 0000-0003-3834-2981
AD  - From the Department of Neurology (S.D., N.C., J.D.S.); Clinical Investigation 
      Center (N.C., J.D.S.), Strasbourg University Hospital; Department of Neurology 
      (B.A.), APHM, Hopital de la Timone, Pole de Neurosciences Cliniques, Marseille; 
      Department of Neurology (X.A.), Montpellier University Hospital; Department of 
      Neurology (B.B.), Rouen University Hospital; Department of Neurology CRC-SEP 
      (J.C.), CHU Toulouse; Department of Neurology, CHU Poitiers (J.C.); Department of 
      Neurology (M.C.), CHU de Nice, UR2CA-URRIS, Nice Cote d'Azur University; 
      Department of Neurology (R.D.), Hopital Fondation Adolphe de Rothschild, Paris; 
      Department of Neurology (F.D.U.R.A.N.D.-D.U.B.I.E.F.), Sclerose en Plaques, 
      Pathologies de la Myeline et Neuro-inflammation, Hopital Neurologique, Hospices 
      Civils de Lyon; Department of Neurology (E.M., C.P.), AP-HP, Pitie-Salpetriere 
      Hospital, Paris; Department of Neurology (Groupe Hospitalier Pellegrin) (A.R.), 
      Centre Hospitalier Universitaire de Bordeaux; Universite de Bordeaux (A.R.), 
      INSERM U1215, Neurocentre Magendie; Department of Neurology (H.Z.), University 
      Hospital of Lille, UFR3S Univ-Lille, Inserm U 1172; Service de Neurologie, 
      Sclerose en Plaques, Pathologies de la Myeline et Neuro Inflammation (R.M.), and 
      Centre de Reference des Maladies Inflammatoires Rares du Cerveau et de la Moelle 
      (MIRCEM), Hopital Neurologique Pierre Wertheimer, Bron; Centre des Neurosciences 
      de Lyon-FORGETTING Team (R.M.), INSERM 1028 and CNRS UMR5292; and Universite 
      Claude Bernard Lyon 1 (R.M.), France.
FAU - Bourre, Bertrand
AU  - Bourre B
AUID- ORCID: 0000-0002-2459-2480
AD  - From the Department of Neurology (S.D., N.C., J.D.S.); Clinical Investigation 
      Center (N.C., J.D.S.), Strasbourg University Hospital; Department of Neurology 
      (B.A.), APHM, Hopital de la Timone, Pole de Neurosciences Cliniques, Marseille; 
      Department of Neurology (X.A.), Montpellier University Hospital; Department of 
      Neurology (B.B.), Rouen University Hospital; Department of Neurology CRC-SEP 
      (J.C.), CHU Toulouse; Department of Neurology, CHU Poitiers (J.C.); Department of 
      Neurology (M.C.), CHU de Nice, UR2CA-URRIS, Nice Cote d'Azur University; 
      Department of Neurology (R.D.), Hopital Fondation Adolphe de Rothschild, Paris; 
      Department of Neurology (F.D.U.R.A.N.D.-D.U.B.I.E.F.), Sclerose en Plaques, 
      Pathologies de la Myeline et Neuro-inflammation, Hopital Neurologique, Hospices 
      Civils de Lyon; Department of Neurology (E.M., C.P.), AP-HP, Pitie-Salpetriere 
      Hospital, Paris; Department of Neurology (Groupe Hospitalier Pellegrin) (A.R.), 
      Centre Hospitalier Universitaire de Bordeaux; Universite de Bordeaux (A.R.), 
      INSERM U1215, Neurocentre Magendie; Department of Neurology (H.Z.), University 
      Hospital of Lille, UFR3S Univ-Lille, Inserm U 1172; Service de Neurologie, 
      Sclerose en Plaques, Pathologies de la Myeline et Neuro Inflammation (R.M.), and 
      Centre de Reference des Maladies Inflammatoires Rares du Cerveau et de la Moelle 
      (MIRCEM), Hopital Neurologique Pierre Wertheimer, Bron; Centre des Neurosciences 
      de Lyon-FORGETTING Team (R.M.), INSERM 1028 and CNRS UMR5292; and Universite 
      Claude Bernard Lyon 1 (R.M.), France.
FAU - Ciron, Jonathan
AU  - Ciron J
AUID- ORCID: 0000-0002-3386-6308
AD  - From the Department of Neurology (S.D., N.C., J.D.S.); Clinical Investigation 
      Center (N.C., J.D.S.), Strasbourg University Hospital; Department of Neurology 
      (B.A.), APHM, Hopital de la Timone, Pole de Neurosciences Cliniques, Marseille; 
      Department of Neurology (X.A.), Montpellier University Hospital; Department of 
      Neurology (B.B.), Rouen University Hospital; Department of Neurology CRC-SEP 
      (J.C.), CHU Toulouse; Department of Neurology, CHU Poitiers (J.C.); Department of 
      Neurology (M.C.), CHU de Nice, UR2CA-URRIS, Nice Cote d'Azur University; 
      Department of Neurology (R.D.), Hopital Fondation Adolphe de Rothschild, Paris; 
      Department of Neurology (F.D.U.R.A.N.D.-D.U.B.I.E.F.), Sclerose en Plaques, 
      Pathologies de la Myeline et Neuro-inflammation, Hopital Neurologique, Hospices 
      Civils de Lyon; Department of Neurology (E.M., C.P.), AP-HP, Pitie-Salpetriere 
      Hospital, Paris; Department of Neurology (Groupe Hospitalier Pellegrin) (A.R.), 
      Centre Hospitalier Universitaire de Bordeaux; Universite de Bordeaux (A.R.), 
      INSERM U1215, Neurocentre Magendie; Department of Neurology (H.Z.), University 
      Hospital of Lille, UFR3S Univ-Lille, Inserm U 1172; Service de Neurologie, 
      Sclerose en Plaques, Pathologies de la Myeline et Neuro Inflammation (R.M.), and 
      Centre de Reference des Maladies Inflammatoires Rares du Cerveau et de la Moelle 
      (MIRCEM), Hopital Neurologique Pierre Wertheimer, Bron; Centre des Neurosciences 
      de Lyon-FORGETTING Team (R.M.), INSERM 1028 and CNRS UMR5292; and Universite 
      Claude Bernard Lyon 1 (R.M.), France.
FAU - Cohen, Mikael
AU  - Cohen M
AD  - From the Department of Neurology (S.D., N.C., J.D.S.); Clinical Investigation 
      Center (N.C., J.D.S.), Strasbourg University Hospital; Department of Neurology 
      (B.A.), APHM, Hopital de la Timone, Pole de Neurosciences Cliniques, Marseille; 
      Department of Neurology (X.A.), Montpellier University Hospital; Department of 
      Neurology (B.B.), Rouen University Hospital; Department of Neurology CRC-SEP 
      (J.C.), CHU Toulouse; Department of Neurology, CHU Poitiers (J.C.); Department of 
      Neurology (M.C.), CHU de Nice, UR2CA-URRIS, Nice Cote d'Azur University; 
      Department of Neurology (R.D.), Hopital Fondation Adolphe de Rothschild, Paris; 
      Department of Neurology (F.D.U.R.A.N.D.-D.U.B.I.E.F.), Sclerose en Plaques, 
      Pathologies de la Myeline et Neuro-inflammation, Hopital Neurologique, Hospices 
      Civils de Lyon; Department of Neurology (E.M., C.P.), AP-HP, Pitie-Salpetriere 
      Hospital, Paris; Department of Neurology (Groupe Hospitalier Pellegrin) (A.R.), 
      Centre Hospitalier Universitaire de Bordeaux; Universite de Bordeaux (A.R.), 
      INSERM U1215, Neurocentre Magendie; Department of Neurology (H.Z.), University 
      Hospital of Lille, UFR3S Univ-Lille, Inserm U 1172; Service de Neurologie, 
      Sclerose en Plaques, Pathologies de la Myeline et Neuro Inflammation (R.M.), and 
      Centre de Reference des Maladies Inflammatoires Rares du Cerveau et de la Moelle 
      (MIRCEM), Hopital Neurologique Pierre Wertheimer, Bron; Centre des Neurosciences 
      de Lyon-FORGETTING Team (R.M.), INSERM 1028 and CNRS UMR5292; and Universite 
      Claude Bernard Lyon 1 (R.M.), France.
FAU - Deschamps, Romain
AU  - Deschamps R
AUID- ORCID: 0000-0001-6291-8771
AD  - From the Department of Neurology (S.D., N.C., J.D.S.); Clinical Investigation 
      Center (N.C., J.D.S.), Strasbourg University Hospital; Department of Neurology 
      (B.A.), APHM, Hopital de la Timone, Pole de Neurosciences Cliniques, Marseille; 
      Department of Neurology (X.A.), Montpellier University Hospital; Department of 
      Neurology (B.B.), Rouen University Hospital; Department of Neurology CRC-SEP 
      (J.C.), CHU Toulouse; Department of Neurology, CHU Poitiers (J.C.); Department of 
      Neurology (M.C.), CHU de Nice, UR2CA-URRIS, Nice Cote d'Azur University; 
      Department of Neurology (R.D.), Hopital Fondation Adolphe de Rothschild, Paris; 
      Department of Neurology (F.D.U.R.A.N.D.-D.U.B.I.E.F.), Sclerose en Plaques, 
      Pathologies de la Myeline et Neuro-inflammation, Hopital Neurologique, Hospices 
      Civils de Lyon; Department of Neurology (E.M., C.P.), AP-HP, Pitie-Salpetriere 
      Hospital, Paris; Department of Neurology (Groupe Hospitalier Pellegrin) (A.R.), 
      Centre Hospitalier Universitaire de Bordeaux; Universite de Bordeaux (A.R.), 
      INSERM U1215, Neurocentre Magendie; Department of Neurology (H.Z.), University 
      Hospital of Lille, UFR3S Univ-Lille, Inserm U 1172; Service de Neurologie, 
      Sclerose en Plaques, Pathologies de la Myeline et Neuro Inflammation (R.M.), and 
      Centre de Reference des Maladies Inflammatoires Rares du Cerveau et de la Moelle 
      (MIRCEM), Hopital Neurologique Pierre Wertheimer, Bron; Centre des Neurosciences 
      de Lyon-FORGETTING Team (R.M.), INSERM 1028 and CNRS UMR5292; and Universite 
      Claude Bernard Lyon 1 (R.M.), France.
FAU - Durand-Dubief, Francoise
AU  - Durand-Dubief F
AD  - From the Department of Neurology (S.D., N.C., J.D.S.); Clinical Investigation 
      Center (N.C., J.D.S.), Strasbourg University Hospital; Department of Neurology 
      (B.A.), APHM, Hopital de la Timone, Pole de Neurosciences Cliniques, Marseille; 
      Department of Neurology (X.A.), Montpellier University Hospital; Department of 
      Neurology (B.B.), Rouen University Hospital; Department of Neurology CRC-SEP 
      (J.C.), CHU Toulouse; Department of Neurology, CHU Poitiers (J.C.); Department of 
      Neurology (M.C.), CHU de Nice, UR2CA-URRIS, Nice Cote d'Azur University; 
      Department of Neurology (R.D.), Hopital Fondation Adolphe de Rothschild, Paris; 
      Department of Neurology (F.D.U.R.A.N.D.-D.U.B.I.E.F.), Sclerose en Plaques, 
      Pathologies de la Myeline et Neuro-inflammation, Hopital Neurologique, Hospices 
      Civils de Lyon; Department of Neurology (E.M., C.P.), AP-HP, Pitie-Salpetriere 
      Hospital, Paris; Department of Neurology (Groupe Hospitalier Pellegrin) (A.R.), 
      Centre Hospitalier Universitaire de Bordeaux; Universite de Bordeaux (A.R.), 
      INSERM U1215, Neurocentre Magendie; Department of Neurology (H.Z.), University 
      Hospital of Lille, UFR3S Univ-Lille, Inserm U 1172; Service de Neurologie, 
      Sclerose en Plaques, Pathologies de la Myeline et Neuro Inflammation (R.M.), and 
      Centre de Reference des Maladies Inflammatoires Rares du Cerveau et de la Moelle 
      (MIRCEM), Hopital Neurologique Pierre Wertheimer, Bron; Centre des Neurosciences 
      de Lyon-FORGETTING Team (R.M.), INSERM 1028 and CNRS UMR5292; and Universite 
      Claude Bernard Lyon 1 (R.M.), France.
FAU - Maillart, Elisabeth
AU  - Maillart E
AUID- ORCID: 0000-0001-7699-0328
AD  - From the Department of Neurology (S.D., N.C., J.D.S.); Clinical Investigation 
      Center (N.C., J.D.S.), Strasbourg University Hospital; Department of Neurology 
      (B.A.), APHM, Hopital de la Timone, Pole de Neurosciences Cliniques, Marseille; 
      Department of Neurology (X.A.), Montpellier University Hospital; Department of 
      Neurology (B.B.), Rouen University Hospital; Department of Neurology CRC-SEP 
      (J.C.), CHU Toulouse; Department of Neurology, CHU Poitiers (J.C.); Department of 
      Neurology (M.C.), CHU de Nice, UR2CA-URRIS, Nice Cote d'Azur University; 
      Department of Neurology (R.D.), Hopital Fondation Adolphe de Rothschild, Paris; 
      Department of Neurology (F.D.U.R.A.N.D.-D.U.B.I.E.F.), Sclerose en Plaques, 
      Pathologies de la Myeline et Neuro-inflammation, Hopital Neurologique, Hospices 
      Civils de Lyon; Department of Neurology (E.M., C.P.), AP-HP, Pitie-Salpetriere 
      Hospital, Paris; Department of Neurology (Groupe Hospitalier Pellegrin) (A.R.), 
      Centre Hospitalier Universitaire de Bordeaux; Universite de Bordeaux (A.R.), 
      INSERM U1215, Neurocentre Magendie; Department of Neurology (H.Z.), University 
      Hospital of Lille, UFR3S Univ-Lille, Inserm U 1172; Service de Neurologie, 
      Sclerose en Plaques, Pathologies de la Myeline et Neuro Inflammation (R.M.), and 
      Centre de Reference des Maladies Inflammatoires Rares du Cerveau et de la Moelle 
      (MIRCEM), Hopital Neurologique Pierre Wertheimer, Bron; Centre des Neurosciences 
      de Lyon-FORGETTING Team (R.M.), INSERM 1028 and CNRS UMR5292; and Universite 
      Claude Bernard Lyon 1 (R.M.), France.
FAU - Papeix, Caroline
AU  - Papeix C
AD  - From the Department of Neurology (S.D., N.C., J.D.S.); Clinical Investigation 
      Center (N.C., J.D.S.), Strasbourg University Hospital; Department of Neurology 
      (B.A.), APHM, Hopital de la Timone, Pole de Neurosciences Cliniques, Marseille; 
      Department of Neurology (X.A.), Montpellier University Hospital; Department of 
      Neurology (B.B.), Rouen University Hospital; Department of Neurology CRC-SEP 
      (J.C.), CHU Toulouse; Department of Neurology, CHU Poitiers (J.C.); Department of 
      Neurology (M.C.), CHU de Nice, UR2CA-URRIS, Nice Cote d'Azur University; 
      Department of Neurology (R.D.), Hopital Fondation Adolphe de Rothschild, Paris; 
      Department of Neurology (F.D.U.R.A.N.D.-D.U.B.I.E.F.), Sclerose en Plaques, 
      Pathologies de la Myeline et Neuro-inflammation, Hopital Neurologique, Hospices 
      Civils de Lyon; Department of Neurology (E.M., C.P.), AP-HP, Pitie-Salpetriere 
      Hospital, Paris; Department of Neurology (Groupe Hospitalier Pellegrin) (A.R.), 
      Centre Hospitalier Universitaire de Bordeaux; Universite de Bordeaux (A.R.), 
      INSERM U1215, Neurocentre Magendie; Department of Neurology (H.Z.), University 
      Hospital of Lille, UFR3S Univ-Lille, Inserm U 1172; Service de Neurologie, 
      Sclerose en Plaques, Pathologies de la Myeline et Neuro Inflammation (R.M.), and 
      Centre de Reference des Maladies Inflammatoires Rares du Cerveau et de la Moelle 
      (MIRCEM), Hopital Neurologique Pierre Wertheimer, Bron; Centre des Neurosciences 
      de Lyon-FORGETTING Team (R.M.), INSERM 1028 and CNRS UMR5292; and Universite 
      Claude Bernard Lyon 1 (R.M.), France.
FAU - Ruet, Aurelie
AU  - Ruet A
AD  - From the Department of Neurology (S.D., N.C., J.D.S.); Clinical Investigation 
      Center (N.C., J.D.S.), Strasbourg University Hospital; Department of Neurology 
      (B.A.), APHM, Hopital de la Timone, Pole de Neurosciences Cliniques, Marseille; 
      Department of Neurology (X.A.), Montpellier University Hospital; Department of 
      Neurology (B.B.), Rouen University Hospital; Department of Neurology CRC-SEP 
      (J.C.), CHU Toulouse; Department of Neurology, CHU Poitiers (J.C.); Department of 
      Neurology (M.C.), CHU de Nice, UR2CA-URRIS, Nice Cote d'Azur University; 
      Department of Neurology (R.D.), Hopital Fondation Adolphe de Rothschild, Paris; 
      Department of Neurology (F.D.U.R.A.N.D.-D.U.B.I.E.F.), Sclerose en Plaques, 
      Pathologies de la Myeline et Neuro-inflammation, Hopital Neurologique, Hospices 
      Civils de Lyon; Department of Neurology (E.M., C.P.), AP-HP, Pitie-Salpetriere 
      Hospital, Paris; Department of Neurology (Groupe Hospitalier Pellegrin) (A.R.), 
      Centre Hospitalier Universitaire de Bordeaux; Universite de Bordeaux (A.R.), 
      INSERM U1215, Neurocentre Magendie; Department of Neurology (H.Z.), University 
      Hospital of Lille, UFR3S Univ-Lille, Inserm U 1172; Service de Neurologie, 
      Sclerose en Plaques, Pathologies de la Myeline et Neuro Inflammation (R.M.), and 
      Centre de Reference des Maladies Inflammatoires Rares du Cerveau et de la Moelle 
      (MIRCEM), Hopital Neurologique Pierre Wertheimer, Bron; Centre des Neurosciences 
      de Lyon-FORGETTING Team (R.M.), INSERM 1028 and CNRS UMR5292; and Universite 
      Claude Bernard Lyon 1 (R.M.), France.
FAU - Zephir, Helene
AU  - Zephir H
AD  - From the Department of Neurology (S.D., N.C., J.D.S.); Clinical Investigation 
      Center (N.C., J.D.S.), Strasbourg University Hospital; Department of Neurology 
      (B.A.), APHM, Hopital de la Timone, Pole de Neurosciences Cliniques, Marseille; 
      Department of Neurology (X.A.), Montpellier University Hospital; Department of 
      Neurology (B.B.), Rouen University Hospital; Department of Neurology CRC-SEP 
      (J.C.), CHU Toulouse; Department of Neurology, CHU Poitiers (J.C.); Department of 
      Neurology (M.C.), CHU de Nice, UR2CA-URRIS, Nice Cote d'Azur University; 
      Department of Neurology (R.D.), Hopital Fondation Adolphe de Rothschild, Paris; 
      Department of Neurology (F.D.U.R.A.N.D.-D.U.B.I.E.F.), Sclerose en Plaques, 
      Pathologies de la Myeline et Neuro-inflammation, Hopital Neurologique, Hospices 
      Civils de Lyon; Department of Neurology (E.M., C.P.), AP-HP, Pitie-Salpetriere 
      Hospital, Paris; Department of Neurology (Groupe Hospitalier Pellegrin) (A.R.), 
      Centre Hospitalier Universitaire de Bordeaux; Universite de Bordeaux (A.R.), 
      INSERM U1215, Neurocentre Magendie; Department of Neurology (H.Z.), University 
      Hospital of Lille, UFR3S Univ-Lille, Inserm U 1172; Service de Neurologie, 
      Sclerose en Plaques, Pathologies de la Myeline et Neuro Inflammation (R.M.), and 
      Centre de Reference des Maladies Inflammatoires Rares du Cerveau et de la Moelle 
      (MIRCEM), Hopital Neurologique Pierre Wertheimer, Bron; Centre des Neurosciences 
      de Lyon-FORGETTING Team (R.M.), INSERM 1028 and CNRS UMR5292; and Universite 
      Claude Bernard Lyon 1 (R.M.), France.
FAU - Marignier, Romain
AU  - Marignier R
AD  - From the Department of Neurology (S.D., N.C., J.D.S.); Clinical Investigation 
      Center (N.C., J.D.S.), Strasbourg University Hospital; Department of Neurology 
      (B.A.), APHM, Hopital de la Timone, Pole de Neurosciences Cliniques, Marseille; 
      Department of Neurology (X.A.), Montpellier University Hospital; Department of 
      Neurology (B.B.), Rouen University Hospital; Department of Neurology CRC-SEP 
      (J.C.), CHU Toulouse; Department of Neurology, CHU Poitiers (J.C.); Department of 
      Neurology (M.C.), CHU de Nice, UR2CA-URRIS, Nice Cote d'Azur University; 
      Department of Neurology (R.D.), Hopital Fondation Adolphe de Rothschild, Paris; 
      Department of Neurology (F.D.U.R.A.N.D.-D.U.B.I.E.F.), Sclerose en Plaques, 
      Pathologies de la Myeline et Neuro-inflammation, Hopital Neurologique, Hospices 
      Civils de Lyon; Department of Neurology (E.M., C.P.), AP-HP, Pitie-Salpetriere 
      Hospital, Paris; Department of Neurology (Groupe Hospitalier Pellegrin) (A.R.), 
      Centre Hospitalier Universitaire de Bordeaux; Universite de Bordeaux (A.R.), 
      INSERM U1215, Neurocentre Magendie; Department of Neurology (H.Z.), University 
      Hospital of Lille, UFR3S Univ-Lille, Inserm U 1172; Service de Neurologie, 
      Sclerose en Plaques, Pathologies de la Myeline et Neuro Inflammation (R.M.), and 
      Centre de Reference des Maladies Inflammatoires Rares du Cerveau et de la Moelle 
      (MIRCEM), Hopital Neurologique Pierre Wertheimer, Bron; Centre des Neurosciences 
      de Lyon-FORGETTING Team (R.M.), INSERM 1028 and CNRS UMR5292; and Universite 
      Claude Bernard Lyon 1 (R.M.), France.
FAU - De Seze, Jerome
AU  - De Seze J
AD  - From the Department of Neurology (S.D., N.C., J.D.S.); Clinical Investigation 
      Center (N.C., J.D.S.), Strasbourg University Hospital; Department of Neurology 
      (B.A.), APHM, Hopital de la Timone, Pole de Neurosciences Cliniques, Marseille; 
      Department of Neurology (X.A.), Montpellier University Hospital; Department of 
      Neurology (B.B.), Rouen University Hospital; Department of Neurology CRC-SEP 
      (J.C.), CHU Toulouse; Department of Neurology, CHU Poitiers (J.C.); Department of 
      Neurology (M.C.), CHU de Nice, UR2CA-URRIS, Nice Cote d'Azur University; 
      Department of Neurology (R.D.), Hopital Fondation Adolphe de Rothschild, Paris; 
      Department of Neurology (F.D.U.R.A.N.D.-D.U.B.I.E.F.), Sclerose en Plaques, 
      Pathologies de la Myeline et Neuro-inflammation, Hopital Neurologique, Hospices 
      Civils de Lyon; Department of Neurology (E.M., C.P.), AP-HP, Pitie-Salpetriere 
      Hospital, Paris; Department of Neurology (Groupe Hospitalier Pellegrin) (A.R.), 
      Centre Hospitalier Universitaire de Bordeaux; Universite de Bordeaux (A.R.), 
      INSERM U1215, Neurocentre Magendie; Department of Neurology (H.Z.), University 
      Hospital of Lille, UFR3S Univ-Lille, Inserm U 1172; Service de Neurologie, 
      Sclerose en Plaques, Pathologies de la Myeline et Neuro Inflammation (R.M.), and 
      Centre de Reference des Maladies Inflammatoires Rares du Cerveau et de la Moelle 
      (MIRCEM), Hopital Neurologique Pierre Wertheimer, Bron; Centre des Neurosciences 
      de Lyon-FORGETTING Team (R.M.), INSERM 1028 and CNRS UMR5292; and Universite 
      Claude Bernard Lyon 1 (R.M.), France. Jerome.DESEZE@chru-strasbourg.fr.
CN  - NOMADMUS Study Group
LA  - eng
SI  - ClinicalTrials.gov/NCT02850705
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20230608
PL  - United States
TA  - Neurology
JT  - Neurology
JID - 0401060
RN  - 4F4X42SYQ6 (Rituximab)
RN  - 0 (anti-aquaporin 4 autoantibody)
RN  - 0 (Autoantibodies)
SB  - IM
CIN - Neurology. 2023 Jul 25;101(4):153-154. PMID: 37311650
MH  - Humans
MH  - *Neuromyelitis Optica/therapy
MH  - Rituximab
MH  - Autoantibodies
MH  - Disability Evaluation
MH  - Recurrence
PMC - PMC10435052
COIS- S. Demuth reports no disclosures. N. Collongues has received honoraria for 
      consulting or presentation from Biogen Idec, Alexion, Novartis, Merck Serono, 
      Bristol-Myers Squibb, Sanofi-Genzyme, and Roche, and is a member of the Editorial 
      Board of the Journal de la Ligue Francaise contre la Sclerose en plaques. B. 
      Audoin, X. Ayrignac, B. Bourre report no disclosures. J. Ciron has received 
      personal compensation for consulting, serving on a scientific advisory board, 
      speaking, or other activities with Biogen, Novartis, Merck, Sanofi-Genzyme, 
      Roche, Celgene-BMS, Alexion, none related to this study. M. Cohen has received 
      honorarium for participating on scientific advisory boards for Ad Scientiam, 
      Alexion, Biogen, BMS, Horizon therapeutics, Merck, Novartis, Roche, and Teva. R. 
      Deschamps, F. Durand Dubief report no disclosures. E. Maillart reports personal 
      fees from Alexion, Biogen, Merck, Novartis, Roche, Sanofi, and Teva, and grants 
      from Biogen, outside the submitted work. C. Papeix reports no disclosures. A. 
      Ruet reports personal fees and research grants from Biogen, personal fees and 
      research grant from Roche, research grant from Genzyme, personal fees and 
      research grant from Merck, research grant from Bayer, outside the submitted work. 
      H. Zephir has received consulting fees from Biogen Idec, Roche, Alexion, BMS, 
      Sanofi, Merck, and Novartis but reports no disclosures directly related to the 
      manuscript. R. Marignier serves on the scientific advisory board for Viela Bio, 
      Roche, UCB, and Alexion, and has received honoraria from Biogen, Merck, and 
      Novartis. J. de Seze reports no disclosures. Go to Neurology.org/N for full 
      disclosures.
EDAT- 2023/06/09 01:09
MHDA- 2023/07/26 06:43
PMCR- 2024/07/25
CRDT- 2023/06/08 21:53
PHST- 2022/08/21 00:00 [received]
PHST- 2023/04/07 00:00 [accepted]
PHST- 2024/07/25 00:00 [pmc-release]
PHST- 2023/07/26 06:43 [medline]
PHST- 2023/06/09 01:09 [pubmed]
PHST- 2023/06/08 21:53 [entrez]
AID - WNL.0000000000207443 [pii]
AID - WNL-2023-000276 [pii]
AID - 10.1212/WNL.0000000000207443 [doi]
PST - ppublish
SO  - Neurology. 2023 Jul 25;101(4):e438-e450. doi: 10.1212/WNL.0000000000207443. Epub 
      2023 Jun 8.