{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T00:18:31Z","timestamp":1792801111079,"version":"4.5.0"},"reference-count":106,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Pract Neurol"],"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:p>Rituximab is a widely used B-cell-depleting monoclonal antibody. It is unlicensed for use in neurological disorders and there are no treatment guidelines. However, as a rapidly acting, targeted therapy with growing evidence of efficacy and tolerability in several neuroinflammatory disorders, it is an attractive alternative to conventional immunomodulatory medications. This practical review aims to explain the basic principles of B-cell depletion with therapeutic monoclonal antibodies. We present the evidence for using rituximab in neurological diseases, and describe the practical aspects of prescribing, including dosing, monitoring, safety, treatment failure and its use in special circumstances such as coexisting viral hepatitis, pregnancy and lactation. We provide an administration guide, checklist and patient information leaflet, which can be adapted for local use. Finally, we review the safety data of rituximab and ocrelizumab (a newer and recently licensed B-cell-depleting therapy for multiple sclerosis) and suggest monitoring and risk reduction strategies.<\/jats:p>","DOI":"10.1136\/practneurol-2018-001899","type":"journal-article","created":{"date-parts":[[2018,11,29]],"date-time":"2018-11-29T17:25:11Z","timestamp":1543512311000},"page":"5-20","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":87,"title":["Rituximab in neurological disease: principles, evidence and practice"],"prefix":"10.1136","volume":"19","author":[{"given":"Daniel H","family":"Whittam","sequence":"first","affiliation":[{"name":"Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma C","family":"Tallantyre","sequence":"additional","affiliation":[{"name":"Helen Durham Centre for Neuroinflammation, University Hospital or Wales, Cardiff, UK"},{"name":"Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Jolles","sequence":"additional","affiliation":[{"name":"Immunodeficiency Centre for Wales, University Hospital of Wales, Cardiff, UK"},{"name":"School of Medicine, Cardiff University, Cardiff, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saif","family":"Huda","sequence":"additional","affiliation":[{"name":"Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J","family":"Moots","sequence":"additional","affiliation":[{"name":"Department of Musculoskeletal Diseases, Institute of Ageing and Chronic Diseases, University of Liverpool, Liverpool, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ho Jin","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Neurology, Research Institute and Hospital of National Cancer Center, Goyang, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil P","family":"Robertson","sequence":"additional","affiliation":[{"name":"Helen Durham Centre for Neuroinflammation, University Hospital or Wales, Cardiff, UK"},{"name":"Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce A C","family":"Cree","sequence":"additional","affiliation":[{"name":"Weill Institute for Neurosciences, University of California, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anu","family":"Jacob","sequence":"additional","affiliation":[{"name":"Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, UK"},{"name":"School of Medicine, University of Liverpool, Liverpool, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,11,29]]},"reference":[{"issue":"S1","key":"2025090409455326000_19.1.5.1","first-page":"47","article-title":"Human peripheral blood B-cell compartments: a crossroad in B-cell traffic","volume":"78","author":"Perez-Andres","year":"2010","journal-title":"Cytometry B Clin Cytom"},{"key":"2025090409455326000_19.1.5.2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awm038"},{"key":"2025090409455326000_19.1.5.3","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/j.ebiom.2017.01.042","article-title":"Memory B-cells are major targets for effective immunotherapy in relapsing multiple sclerosis","volume":"16","author":"Baker","year":"2017","journal-title":"EBioMedicine"},{"key":"2025090409455326000_19.1.5.4","doi-asserted-by":"publisher","DOI":"10.1001\/archneurol.2011.154"},{"key":"2025090409455326000_19.1.5.5","doi-asserted-by":"publisher","DOI":"10.1177\/1352458515620934"},{"key":"2025090409455326000_19.1.5.6","unstructured":"British National Formulary: Rituximab , 2018. https:\/\/bnf.nice.org.uk\/drug\/rituximab.html [accessed 7th Mar]."},{"key":"2025090409455326000_19.1.5.7","doi-asserted-by":"publisher","DOI":"10.1002\/ana.21363"},{"key":"2025090409455326000_19.1.5.8","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1056\/NEJMoa0706383","article-title":"B-cell depletion with rituximab in relapsing\u2013remitting multiple sclerosis","volume":"358","author":"Hauser","year":"2008","journal-title":"N Engl J Med Overseas Ed"},{"key":"2025090409455326000_19.1.5.9","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3181e24373"},{"key":"2025090409455326000_19.1.5.10","doi-asserted-by":"publisher","DOI":"10.1002\/ana.21867"},{"key":"2025090409455326000_19.1.5.11","doi-asserted-by":"crossref","first-page":"2074","DOI":"10.1212\/WNL.0000000000003331","article-title":"Rituximab in multiple sclerosis: a retrospective observational study on safety and efficacy","volume":"87","author":"Salzer","year":"2016","journal-title":"Neurology"},{"key":"2025090409455326000_19.1.5.12","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1001\/jamaneurol.2017.4011","article-title":"Comparative effectiveness of rituximab and other initial treatment choices for multiple sclerosis","volume":"75","author":"Granqvist","year":"2018","journal-title":"JAMA Neurol"},{"key":"2025090409455326000_19.1.5.13","doi-asserted-by":"crossref","first-page":"1342","DOI":"10.1001\/jamaneurol.2016.1637","article-title":"Efficacy and safety of rituximab therapy in neuromyelitis optica spectrum disorders: a systematic review and meta-analysis","volume":"73","author":"Damato","year":"2016","journal-title":"JAMA Neurol"},{"key":"2025090409455326000_19.1.5.14","doi-asserted-by":"publisher","DOI":"10.1136\/practneurol-2012-000237"},{"key":"2025090409455326000_19.1.5.15","doi-asserted-by":"crossref","first-page":"1683","DOI":"10.1212\/WNL.0000000000002635","article-title":"Rituximab treatment for autoimmune limbic encephalitis in an institutional cohort","volume":"86","author":"Lee","year":"2016","journal-title":"Neurology"},{"key":"2025090409455326000_19.1.5.16","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(12)70310-1"},{"key":"2025090409455326000_19.1.5.17","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000000570"},{"key":"2025090409455326000_19.1.5.18","unstructured":"Clinical Commissioning Policy , 2018. Rituximab for second line treatment for anti-NMDAR autoimmune encephalitis (all ages). NHS England. https:\/\/www.england.nhs.uk\/wp-content\/uploads\/2018\/03\/ccp-rituximab-for-second-line-treatment-for-anti-nmdar-autoimmune-encephalitis.pdf"},{"key":"2025090409455326000_19.1.5.19","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.jneuroim.2014.03.012","article-title":"Long-term remission with rituximab in refractory leucine-rich glioma inactivated 1 antibody encephalitis","volume":"271","author":"Brown","year":"2014","journal-title":"J Neuroimmunol"},{"key":"2025090409455326000_19.1.5.20","doi-asserted-by":"crossref","first-page":"896","DOI":"10.1001\/jamaneurol.2014.463","article-title":"Effect of rituximab in patients with leucine-rich, glioma-inactivated 1 antibody-associated encephalopathy","volume":"71","author":"Irani","year":"2014","journal-title":"JAMA Neurol"},{"key":"2025090409455326000_19.1.5.21","doi-asserted-by":"crossref","first-page":"1637","DOI":"10.1002\/art.39068","article-title":"Adult primary central nervous system vasculitis treatment and course: analysis of one hundred sixty-three patients","volume":"67","author":"Salvarani","year":"2015","journal-title":"Arthritis Rheumatol"},{"key":"2025090409455326000_19.1.5.22","doi-asserted-by":"crossref","unstructured":"Berlit P , Becker J , Kraemer M . Rituximab in primary angiitis of the CNS (P3.076). Neurology 2017;88.","DOI":"10.1212\/WNL.88.16_supplement.P3.076"},{"key":"2025090409455326000_19.1.5.23","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.130529"},{"key":"2025090409455326000_19.1.5.24","doi-asserted-by":"crossref","first-page":"1287","DOI":"10.1212\/WNL.0000000000000293","article-title":"Treatment of primary CNS vasculitis with rituximab: case report","volume":"82","author":"Salvarani","year":"2014","journal-title":"Neurology"},{"key":"2025090409455326000_19.1.5.25","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2016-209133"},{"key":"2025090409455326000_19.1.5.26","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2014-206404"},{"key":"2025090409455326000_19.1.5.27","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0909905"},{"key":"2025090409455326000_19.1.5.28","unstructured":"National Institute for Health and Care Excellence technology appraisal guidance TA308 , 2014. Rituximab in combination with glucocorticoids for treating anti-neutrophil cytoplasmic antibody-associated vasculitis. https:\/\/www.nice.org.uk\/guidance\/ta308\/chapter\/1-Guidance [Accessed 16 Jun 2018]."},{"key":"2025090409455326000_19.1.5.29","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2004.051144"},{"key":"2025090409455326000_19.1.5.30","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2009.06.015"},{"key":"2025090409455326000_19.1.5.31","doi-asserted-by":"crossref","first-page":"237","DOI":"10.2169\/internalmedicine.49.2821","article-title":"Successful treatment with rituximab in a patient with stiff-person syndrome complicated by dysthyroid ophthalmopathy","volume":"49","author":"Katoh","year":"2010","journal-title":"Intern Med"},{"key":"2025090409455326000_19.1.5.32","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1002\/ana.25002","article-title":"A double-blind, placebo-controlled study of rituximab in patients with stiff person syndrome","volume":"82","author":"Dalakas","year":"2017","journal-title":"Ann Neurol"},{"key":"2025090409455326000_19.1.5.33","unstructured":"Clinical Commissioning Policy , 2017. Rituximab for chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), multifocal motor neuropathy (MMN), vasculitis of the peripheral nervous system & IgM paraprotein- associated demyelinating neuropathy (adults). NHS England. https:\/\/www.england.nhs.uk\/publication\/commissioning-policy-rituximab-for-chronic-inflammatory-demyelinating-polyradiculoneuropathy-cidp-multifocal-motor-neuropathy-mmn-vasculitis-of-the-peripheral-nervous-system-igm-paraprotein-a\/"},{"key":"2025090409455326000_19.1.5.34","article-title":"Immunomodulatory treatment other than corticosteroids, immunoglobulin and plasma exchange for chronic inflammatory demyelinating polyradiculoneuropathy","volume":"6","author":"Mahdi-Rogers","year":"2013","journal-title":"Cochrane Database Syst Rev"},{"key":"2025090409455326000_19.1.5.35","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2009.188912"},{"key":"2025090409455326000_19.1.5.36","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1331.2011.03495.x"},{"key":"2025090409455326000_19.1.5.37","doi-asserted-by":"crossref","DOI":"10.1212\/NXI.0000000000000149","article-title":"Rituximab in treatment-resistant CIDP with antibodies against paranodal proteins","volume":"2","author":"Querol","year":"2015","journal-title":"Neurol Neuroimmunol Neuroinflamm"},{"key":"2025090409455326000_19.1.5.38","doi-asserted-by":"crossref","first-page":"1851","DOI":"10.1093\/brain\/awx124","article-title":"Autoantibodies to nodal isoforms of neurofascin in chronic inflammatory demyelinating polyneuropathy","volume":"140","author":"Delmont","year":"2017","journal-title":"Brain"},{"key":"2025090409455326000_19.1.5.39","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.52.8.1701"},{"key":"2025090409455326000_19.1.5.40","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1016\/j.nmd.2009.04.013","article-title":"Beneficial effect of rituximab monotherapy in multifocal motor neuropathy","volume":"19","author":"Stieglbauer","year":"2009","journal-title":"Neuromuscul Disord"},{"key":"2025090409455326000_19.1.5.41","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1111\/j.1529-8027.2010.00270.x","article-title":"An open-label trial of rituximab (Rituxan\u00ae) in multifocal motor neuropathy","volume":"15","author":"Chaudhry","year":"2010","journal-title":"J Peripher Nerv Syst"},{"key":"2025090409455326000_19.1.5.42","doi-asserted-by":"publisher","DOI":"10.1002\/mus.20664"},{"key":"2025090409455326000_19.1.5.43","doi-asserted-by":"publisher","DOI":"10.1111\/j.1529-8027.2010.00281.x"},{"key":"2025090409455326000_19.1.5.44","doi-asserted-by":"publisher","DOI":"10.1177\/1759720X14566617"},{"key":"2025090409455326000_19.1.5.45","doi-asserted-by":"publisher","DOI":"10.1002\/ana.21577"},{"key":"2025090409455326000_19.1.5.46","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e318296e92b"},{"key":"2025090409455326000_19.1.5.47","doi-asserted-by":"publisher","DOI":"10.1002\/mus.10359"},{"key":"2025090409455326000_19.1.5.48","doi-asserted-by":"publisher","DOI":"10.1111\/j.1529-8027.2007.00129.x"},{"key":"2025090409455326000_19.1.5.49","doi-asserted-by":"crossref","first-page":"1742","DOI":"10.1212\/01.wnl.0000335268.70325.33","article-title":"Long-term effect of rituximab in anti-mag polyneuropathy","volume":"71","author":"Benedetti","year":"2008","journal-title":"Neurology"},{"key":"2025090409455326000_19.1.5.50","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2008.155325"},{"key":"2025090409455326000_19.1.5.51","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1212\/WNL.0000000000002790","article-title":"International consensus guidance for management of myasthenia gravis: Executive summary","volume":"87","author":"Sanders","year":"2016","journal-title":"Neurology"},{"key":"2025090409455326000_19.1.5.52","doi-asserted-by":"crossref","first-page":"1115","DOI":"10.1007\/s00415-014-7532-3","article-title":"Efficacy and safety of rituximab for myasthenia gravis: a systematic review and meta-analysis","volume":"262","author":"Iorio","year":"2015","journal-title":"J Neurol"},{"key":"2025090409455326000_19.1.5.53","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1002\/mus.25597","article-title":"Rituximab treatment of myasthenia gravis: a systematic review","volume":"56","author":"Tandan","year":"2017","journal-title":"Muscle Nerve"},{"key":"2025090409455326000_19.1.5.54","doi-asserted-by":"crossref","first-page":"1069","DOI":"10.1212\/WNL.0000000000004341","article-title":"Rituximab as treatment for anti-MuSK myasthenia gravis: multicenter blinded prospective review","volume":"89","author":"Hehir","year":"2017","journal-title":"Neurology"},{"key":"2025090409455326000_19.1.5.55","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3182407982"},{"key":"2025090409455326000_19.1.5.56","unstructured":"Mabthera SmPC , 2018. https:\/\/www.medicines.org.uk\/emc\/product\/3801\/smpc [Accessed 7 Mar 2018]."},{"key":"2025090409455326000_19.1.5.57","doi-asserted-by":"publisher","DOI":"10.1002\/acr.22116"},{"key":"2025090409455326000_19.1.5.58","doi-asserted-by":"publisher","DOI":"10.1002\/art.30152"},{"key":"2025090409455326000_19.1.5.59","doi-asserted-by":"publisher","DOI":"10.1177\/1352458511418631"},{"key":"2025090409455326000_19.1.5.60","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3182a1aac7"},{"key":"2025090409455326000_19.1.5.61","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1007\/s13760-017-0795-6","article-title":"Effectiveness of low dose of rituximab compared with azathioprine in chinese patients with neuromyelitis optica: an over 2-year follow-up study","volume":"117","author":"Zhang","year":"2017","journal-title":"Acta Neurol Belg"},{"key":"2025090409455326000_19.1.5.62","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1016\/j.jns.2017.04.007","article-title":"Lower dosages of rituximab used successfully in the treatment of anti-NMDA receptor encephalitis without tumour","volume":"377","author":"Wang","year":"2017","journal-title":"J Neurol Sci"},{"key":"2025090409455326000_19.1.5.63","doi-asserted-by":"publisher","DOI":"10.1177\/1352458511432896"},{"key":"2025090409455326000_19.1.5.64","doi-asserted-by":"crossref","first-page":"992","DOI":"10.1002\/mus.24063","article-title":"Prolonged B-cell depletion in MuSK myasthenia gravis following rituximab treatment","volume":"48","author":"Yi","year":"2013","journal-title":"Muscle Nerve"},{"key":"2025090409455326000_19.1.5.65","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3182152881"},{"key":"2025090409455326000_19.1.5.66","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1001\/jamaneurol.2013.5699","article-title":"Comparison of relapse and treatment failure rates among patients with neuromyelitis optica: multicenter study of treatment efficacy","volume":"71","author":"Mealy","year":"2014","journal-title":"JAMA Neurol"},{"key":"2025090409455326000_19.1.5.67","doi-asserted-by":"crossref","first-page":"1110","DOI":"10.1001\/jamaneurol.2013.3071","article-title":"A 5-year follow-up of rituximab treatment in patients with neuromyelitis optica spectrum disorder","volume":"70","author":"Kim","year":"2013","journal-title":"JAMA Neurol"},{"key":"2025090409455326000_19.1.5.68","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1016\/j.jns.2017.01.025","article-title":"Monitoring CD27+ memory B-cells in neuromyelitis optica spectrum disorders patients treated with rituximab: Results from a bicentric study","volume":"373","author":"Cohen","year":"2017","journal-title":"J Neurol Sci"},{"key":"2025090409455326000_19.1.5.69","doi-asserted-by":"publisher","DOI":"10.1177\/1756285616632653"},{"key":"2025090409455326000_19.1.5.70","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1111\/nyas.12794","article-title":"Neuromyelitis optica and the evolving spectrum of autoimmune aquaporin-4 channelopathies: a decade later","volume":"1366","author":"Pittock","year":"2016","journal-title":"Ann N Y Acad Sci"},{"key":"2025090409455326000_19.1.5.71","doi-asserted-by":"crossref","first-page":"989","DOI":"10.1001\/jamaneurol.2015.1276","article-title":"Treatment outcomes with rituximab in 100 patients with neuromyelitis optica: Influence of FCGR3A polymorphisms on the therapeutic response to rituximab","volume":"72","author":"Kim","year":"2015","journal-title":"JAMA Neurol"},{"key":"2025090409455326000_19.1.5.72","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2012.02.017"},{"key":"2025090409455326000_19.1.5.73","doi-asserted-by":"crossref","DOI":"10.1212\/NXI.0000000000000061","article-title":"Disease exacerbation after rituximab induction in neuromyelitis optica","volume":"2","author":"Perumal","year":"2015","journal-title":"Neurology - Neuroimmunology Neuroinflammation"},{"key":"2025090409455326000_19.1.5.74","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2010.12.011"},{"key":"2025090409455326000_19.1.5.75","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kes344"},{"key":"2025090409455326000_19.1.5.76","doi-asserted-by":"crossref","first-page":"1224","DOI":"10.1177\/1352458517720044","article-title":"Rituximab in multiple sclerosis: Frequency and clinical relevance of anti-drug antibodies","volume":"24","author":"Dunn","year":"2018","journal-title":"Mult Scler"},{"key":"2025090409455326000_19.1.5.77","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/j.jneuroim.2017.12.021","article-title":"Anti-rituximab antibody in patients with NMOSDs treated with low dose rituximab","volume":"316","author":"Li","year":"2018","journal-title":"J Neuroimmunol"},{"key":"2025090409455326000_19.1.5.78","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2012-201956"},{"key":"2025090409455326000_19.1.5.79","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/ker417"},{"key":"2025090409455326000_19.1.5.80","doi-asserted-by":"publisher","DOI":"10.1002\/art.27555"},{"key":"2025090409455326000_19.1.5.81","doi-asserted-by":"crossref","first-page":"1115","DOI":"10.1007\/s00415-018-8812-0","article-title":"Secondary antibody deficiency and infection following B-cell depletion for CNS neuroinflammation","volume":"265","author":"Tallantyre","year":"2018","journal-title":"J Neurol"},{"key":"2025090409455326000_19.1.5.82","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2010-07-295444"},{"key":"2025090409455326000_19.1.5.83","doi-asserted-by":"crossref","first-page":"1808","DOI":"10.1177\/1352458517740215","article-title":"Neuromyelitis optica spectrum disorders and pregnancy: interactions and management","volume":"23","author":"Shosha","year":"2017","journal-title":"Mult Scler"},{"key":"2025090409455326000_19.1.5.84","doi-asserted-by":"crossref","DOI":"10.1212\/NXI.0000000000000453","article-title":"Rituximab before and during pregnancy: a systematic review, and a case series in MS and NMOSD","volume":"5","author":"Das","year":"2018","journal-title":"Neurol Neuroimmunol Neuroinflamm"},{"key":"2025090409455326000_19.1.5.85","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1056\/NEJMoa1601277","article-title":"Ocrelizumab versus interferon beta-1a in relapsing multiple sclerosis","volume":"376","author":"Hauser","year":"2017","journal-title":"N Engl J Med Overseas Ed"},{"key":"2025090409455326000_19.1.5.86","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1606468"},{"key":"2025090409455326000_19.1.5.87","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0087379","article-title":"Safety with ocrelizumab in rheumatoid arthritis: results from the ocrelizumab phase iii pty with Ocrelizumab in Rheumatoid Arthritis: Results from the Ocrelizumab Phase III Program","volume":"9","author":"Emery","year":"2014","journal-title":"PLoS One"},{"key":"2025090409455326000_19.1.5.88","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0037626","article-title":"Impact of rituximab on immunoglobulin concentrations and B-cell numbers after cyclophosphamide treatment in patients with ANCA-associated vasculitides","volume":"7","author":"Venhoff","year":"2012","journal-title":"PLoS One"},{"key":"2025090409455326000_19.1.5.89","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1111\/cei.12915","article-title":"When to initiate immunoglobulin replacement therapy (IGRT) in antibody deficiency: a practical approach","volume":"188","author":"Jolles","year":"2017","journal-title":"Clin Exp Immunol"},{"key":"2025090409455326000_19.1.5.90","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2011.01.035"},{"key":"2025090409455326000_19.1.5.91","unstructured":"Wimperis J , Lunn M , Jones A , 2011. Department of health clinical guidelines for immunoglobulin use: second edition update. Available from: https:\/\/www.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/216671\/dh_131107.pdf [Accessed Jul 2011]."},{"key":"2025090409455326000_19.1.5.92","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1089\/bfm.2014.0107","article-title":"Lactation and the use of biologic immunosuppressive medications","volume":"9","author":"Witzel","year":"2014","journal-title":"Breastfeed Med"},{"key":"2025090409455326000_19.1.5.93","unstructured":"Medicines and Healthcare products Regulatory Agency , 2013. Rituximab: screen for hepatitis B virus before treatment. MRHA Alert. Available from: https:\/\/www.gov.uk\/drug-safety-update\/rituximab-screen-for-hepatitis-b-virus-before-treatment"},{"key":"2025090409455326000_19.1.5.94","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1038\/nrgastro.2013.216","article-title":"Management of patients with hepatitis B who require immunosuppressive therapy","volume":"11","author":"Hwang","year":"2014","journal-title":"Nat Rev Gastroenterol Hepatol"},{"key":"2025090409455326000_19.1.5.95","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/656340"},{"key":"2025090409455326000_19.1.5.96","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmii.2011.12.020"},{"key":"2025090409455326000_19.1.5.97","doi-asserted-by":"publisher","DOI":"10.1155\/2017\/9478542"},{"key":"2025090409455326000_19.1.5.98","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2010.144998"},{"key":"2025090409455326000_19.1.5.99","doi-asserted-by":"publisher","DOI":"10.1002\/art.25034"},{"key":"2025090409455326000_19.1.5.100","doi-asserted-by":"publisher","DOI":"10.1111\/ene.12132"},{"key":"2025090409455326000_19.1.5.101","doi-asserted-by":"publisher","DOI":"10.1136\/rmdopen-2014-000034"},{"key":"2025090409455326000_19.1.5.102","doi-asserted-by":"crossref","unstructured":"Seibert J , Blackburn J , Vollmer B . Safety, tolerability, and efficacy of rituximab in the treatment of multiple sclerosis: 285 patients treated in a single center. Neurology 2015;84.","DOI":"10.1212\/WNL.84.14_supplement.P3.262"},{"key":"2025090409455326000_19.1.5.103","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1016\/j.msard.2013.08.001","article-title":"Late-onset neutropenia during long-term rituximab therapy in neuromyelitis optica","volume":"3","author":"Plate","year":"2014","journal-title":"Mult Scler Relat Disord"},{"key":"2025090409455326000_19.1.5.104","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.jneuroim.2015.08.003","article-title":"Favorable outcome of granulocyte colony-stimulating factor use in neuromyelitis optica patients presenting with agranulocytosis in the setting of rituximab","volume":"287","author":"Mealy","year":"2015","journal-title":"J Neuroimmunol"},{"key":"2025090409455326000_19.1.5.105","doi-asserted-by":"crossref","first-page":"211","DOI":"10.12659\/AJCR.892541","article-title":"Rituximab-related late-onset neutropenia in patients with rheumatic diseases: successful re-challenge of the treatment","volume":"16","author":"Reitblat","year":"2015","journal-title":"Am J Case Rep"},{"key":"2025090409455326000_19.1.5.106","doi-asserted-by":"publisher","DOI":"10.1177\/2042098612453849"}],"container-title":["Practical Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/practneurol-2018-001899","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T16:46:11Z","timestamp":1757004371000},"score":1,"resource":{"primary":{"URL":"https:\/\/pn.bmj.com\/lookup\/doi\/10.1136\/practneurol-2018-001899"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,11,29]]},"references-count":106,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2019,1,17]]},"published-print":{"date-parts":[[2019,2]]}},"alternative-id":["10.1136\/practneurol-2018-001899"],"URL":"https:\/\/doi.org\/10.1136\/practneurol-2018-001899","relation":{},"ISSN":["1474-7758","1474-7766"],"issn-type":[{"value":"1474-7758","type":"print"},{"value":"1474-7766","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,11,29]]}}}