Rituxan for Gullain-Barre Syndrome – pro

Guillain-Barré syndrome is a disorder in which the body’s immune system attacks part of the peripheral nervous system. Symptoms include varying degrees of weakness or tingling sensations in the legs. Sometimes, the weakness and abnormal sensations spread to the arms and upper body and progress to paralysis. There is no known cure for Guillain-Barré syndrome, but therapies can lessen the severity of the illness and accelerate the recovery in most patients. Currently, plasmapheresis and high-dose immunoglobulin therapy are most often used.

GB syndrome can occurr is association with various conditions, as a paraneopastic syndrome or secondary to a viral infection. Rituximab has also been reported to be associated with causing GB, probably through its anti-immune effect. There are also reports of rituximab association with improvement in GB. Review of the literature finds only case report level evidence to support rituximab for GB. The plan states: “Experimental means any treatment where the stated proposed treatment has no supporting literature for safety or efficacy in human trials”. Since this is the case for rituximab for GB, it should be considered investigational.

Ostronoff F, Perales MA, Stubblefield MD, Hsu KC.Rituximab-responsive Guillain-Barré syndrome following allogeneic hematopoietic SCT.Bone Marrow Transplant. 2008 Jul;42(1):71-2.

Carmona, Alberto1; Alonso, Juan; Heras, Manuel; Navarrete, AgustínGuillain-Barre syndrome in a patient with diffuse large B-cell lymphoma, and rituximab maintenance therapy. An association beyound anecdotal evidence?  Clinical and Translational Oncology, Volume 8, Number 10, October 2006 , pp. 764-766(3)

Terenghi F, Ardolino G, Nobile-Orazio EGuillain-Barré syndrome after combined CHOP and rituximab therapy in non-Hodgkin lymphoma.Peripher Nerv Syst. 2007 Jun;12(2):142-3.

 

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