Anti-MAG antibodies in 202 patients: clinicopathological and therapeutic features.

Details

Serval ID
serval:BIB_8FE5A2441A77
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Anti-MAG antibodies in 202 patients: clinicopathological and therapeutic features.
Journal
Journal of neurology, neurosurgery, and psychiatry
Author(s)
Svahn J., Petiot P., Antoine J.C., Vial C., Delmont E., Viala K., Steck A.J., Magot A., Cauquil C., Zarea A., Echaniz-Laguna A., Iancu Ferfoglia R., Gueguen A., Magy L., Léger J.M., Kuntzer T., Ferraud K., Lacour A., Camdessanché J.P.
Working group(s)
Francophone anti-MAG cohort Group
ISSN
1468-330X (Electronic)
ISSN-L
0022-3050
Publication state
Published
Issued date
05/2018
Peer-reviewed
Oui
Volume
89
Number
5
Pages
499-505
Language
english
Notes
Publication types: Clinical Trial ; Journal Article ; Multicenter Study
Publication Status: ppublish
Abstract
To assess the clinicopathological and therapeutic features of patients with low (≥1000 to <10 000 Bühlmann Titre Units) (BTU), medium (10 000-70 000) or high (≥70 000) anti-myelin-associated glycoprotein (anti-MAG) antibody titres.
We retrospectively and prospectively analysed standardised report forms and medical records of 202 patients from 14 neuromuscular centres.
Mean age at onset and mean time between symptom onset to last follow-up were respectively 62.6 years (25-91.4) and 8.4 years (0.3-33.3). Anti-MAG antibody titres at diagnosis were low, medium or high in 11%, 51% and 38% of patients. Patients presented with monoclonal gammopathy of undetermined significance in 68% of cases. About 17% of patients presented with 'atypical' clinical phenotype independently of anti-MAG titres, including acute or chronic sensorimotor polyradiculoneuropathies (12.4%), and asymmetric or multifocal neuropathy (3%). At the most severe disease stage, 22.4% of patients were significantly disabled. Seventy-eight per cent of patients received immunotherapies. Transient clinical worsening was observed in 12% of patients treated with rituximab (11/92). Stabilisation after rituximab treatment during the 7-12-month follow-up period was observed in 29% of patients. Clinical response to rituximab during the 6-month and/or 7-12-month follow-up period was observed in 31.5% of patients and correlated with anti-MAG titre ≥10 000 BTU.
Our study highlights the extended clinical spectrum of patients with anti-MAG neuropathy, which appears unrelated to antibody titre. Besides, it may also suggest beneficial use of rituximab in the early phase of anti-MAG neuropathy.
Keywords
Adult, Aged, Aged, 80 and over, Autoantibodies/blood, Drug Therapy, Combination, Female, Humans, Immunologic Factors/therapeutic use, Immunosuppressive Agents/therapeutic use, Male, Middle Aged, Myelin-Associated Glycoprotein/immunology, Paraproteinemias/blood, Paraproteinemias/drug therapy, Paraproteinemias/immunology, Polyneuropathies/blood, Polyneuropathies/drug therapy, Polyneuropathies/immunology, Prospective Studies, Retrospective Studies, Rituximab/therapeutic use
Pubmed
Web of science
Create date
09/11/2017 19:26
Last modification date
09/10/2019 5:09
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