Rituximab in patients with pediatric multiple sclerosis and other demyelinating disorders of the CNS: Practical considerations.

Ghezzi, Angelo; Banwell, Brenda; Bar-Or, Amit; Chitnis, Tanuja; Dale, Russell C; Gorman, Mark; Kornek, Barbara; Krupp, Lauren; Krysko, Kristen M; Nosadini, Margherita; Rostasy, Kevin; Salzer, Jonatan; Schreiner, Teri; Tenembaum, Silvia; Waubant, Emmanuelle

Anti-CD20 therapies have established efficacy in the treatment of immune-mediated neurological and non-neurological diseases. Rituximab, one of the first B-cell-directed therapies, is relatively inexpensive compared to newer anti-CD20 molecules, is available in many countries, and has been used off-label in pediatric patients with neuroimmune conditions. The objective of this paper is to describe the experience with rituximab in pediatric multiple sclerosis and other inflammatory immune-mediated disorders of the central nervous system (CNS), and to define a protocol for its use in clinical practice, in particular addressing doses, interval of administration, duration of treatment, and tests to perform at baseline and during follow-up.