Rituximab in the treatment of peripheral neuropathy associated with monoclonal gammopathy

Abstract

Peripheral neuropathy associated with immunoglobulin (Ig)M gammopathy and anti-myelin-associated glycoprotein antibodies is frequently treatment-resistant and different treatment regimens carry substantial toxicity and side effects. More recently, the chimeric anti-CD20 monoclonal antibody rituximab has shown benefits in the treatment of peripheral neuropathy associated with IgM gammopathy with a favorable side-effect profile. There are no published reports of its use in the treatment of neuropathy associated with IgG and IgA gammopathies. Rituximab is usually given at 375 mg/m² intravenously with four weekly doses that may be repeated after 6–12 months. Large controlled studies are still pending but rituximab is an exciting and promising treatment offering another option in the treatment of peripheral neuropathy associated with IgM monoclonal gammopathy.

Keywords::

• anti-MAG antibody
• CD20
• immunoglobulinM
• monoclonal gammopathy
• peripheral neuropathy
• rituximab