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Response to Letter to the Editor| Volume 319, ISSUE 1-2, P172, August 15, 2012

Lack of response to rituximab therapy in patients with neuromyelitis optica: Response to Kim and Kim

      When confronted with an unsatisfactory response to treatment, the physician has to decide what to do next. Should one give more of the same treatment, or change to a different treatment? Was the treatment not effective for the disease, or was the amount given insufficient? Should one try harder with the same approach, or do something different? Drs. Kim and Kim raise this question in regard to our recent report of our experience with rituximab (RTX) in neuromyelitis optica (NMO) [
      • Lindsey J.W.
      • Meulmester K.M.
      • Brod S.A.
      • Nelson F.
      • Wolinsky J.S.
      Variable results after rituximab in neuromyelitis optica.
      ], and suggest that our patients received insufficient treatment. We disagree, and are not convinced that RTX is of benefit for all cases of NMO.
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      References

        • Lindsey J.W.
        • Meulmester K.M.
        • Brod S.A.
        • Nelson F.
        • Wolinsky J.S.
        Variable results after rituximab in neuromyelitis optica.
        J Neurol Sci. 2012; 317: 103-105
        • Wingerchuk D.M.
        • Weinshenker B.G.
        White matter disease: optimizing rituximab therapy for neuromyelitis optica.
        Nat Rev Neurol. 2011; 12: 664-665
        • Kim S.H.
        • Kim W.
        • Li X.F.
        • Jung I.J.
        • Kim H.J.
        Repeated treatment with rituximab based on the assessment of peripheral circulating memory B cells in patients with relapsing neuromyelitis optica over 2 years.
        Arch Neurol. 2011; 68: 1412-1420