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Case Reports
. 2022 Mar 28:14:11795735221084837.
doi: 10.1177/11795735221084837. eCollection 2022.

Recovery of Chronic Inflammatory Demyelinating Polyneuropathy on Treatment With Ocrelizumab in a Patient With Co-Existing Multiple Sclerosis

Michael Auer  1 , Harald Hegen  1 , Anna Hotter  1 , Wolfgang Löscher  1 , Klaus Berek  1 , Anne Zinganell  1 , Elena Fava  1 , Paul Rhomberg  2 , Florian Deisenhammer  1 , Franziska Di Pauli  1
Affiliations
Case Reports

Recovery of Chronic Inflammatory Demyelinating Polyneuropathy on Treatment With Ocrelizumab in a Patient With Co-Existing Multiple Sclerosis

Michael Auer et al. J Cent Nerv Syst Dis. .

Abstract

The chimeric anti-CD20 antibody rituximab has demonstrated good efficacy as an off-label treatment in chronic inflammatory demyelinating polyneuropathy (CIDP), while the humanized anti-CD20 antibody ocrelizumab has been approved for treatment of multiple sclerosis (MS), whereas there is no evidence for its use in CIDP so far. We present a patient suffering from CIDP and MS, both refractory to standard treatment and both showing marked improvement on ocrelizumab. To the best of our knowledge, this is a unique report of CIDP with an almost full electrophysiological recovery on ocrelizumab which could be considered as a potential treatment option for refractory CIDP.

Keywords: anti-CD20; chronic inflammatory demyelinating polyneuropathy; multiple sclerosis; ocrelizumab; off-label; treatment.

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Conflict of interest statement

Declaration of conflicting interests: The authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Michael Auer has participated in meetings sponsored by, received speaker honoraria or travel funding from Biogen, Novartis, Merck and Sanofi-Genzyme. Harald Hegen has participated in meetings sponsored by, received speaker honoraria or travel funding from Bayer, Biogen, Merck, Novartis, Sanofi-Genzyme, Siemens, Teva, and received honoraria for acting as consultant for Biogen and Teva. Anna Hotter and Wolfgang Löscher report no conflicts of interest. Klaus Berek has participated in meetings sponsored by and received travel funding from Roche and Biogen. Anne Zinganell has participated in meetings sponsored by, received honoraria or travel funding from Biogen, Merck, Sanofi-Genzyme, Teva and Roche. Elena Fava has participated in meetings sponsored by and received travel funding from Teva, Biogen. Florian Deisenhammer has participated in meetings sponsored by or received honoraria for acting as an advisor/speaker for Almirall, Alexion, Biogen, Celgene, Genzyme-Sanofi, Merck, Novartis Pharma, Roche, and TEVA ratiopharm. His institution has received research grants from Biogen and Genzyme-Sanofi. He is section editor of the MSARD Journal (Multiple Sclerosis and Related Disorders). Franziska Di Pauli has participated in meetings sponsored by, received honoraria (lectures, advisory boards,and consultations) or travel funding from Bayer, Biogen, Celgene, Merck, Novartis, Sanofi-Genzyme, Roche and Teva. Her institution has received research grants from Roche.

Figures

Figure 1.
Figure 1.
Brain MRI before start of ocrelizumab. April 24, 2020. Brain MRI after multiple sclerosis relapse and high-dose intravenous methylprednisolone therapy, while on treatment with dimethylfumarate, revealed multiple T2 hyperintense white matter lesions, partially in typical areas for multiple sclerosis (A: T2-weighted images) and several of them with contrast enhancement (B: T1-weigted images with gadolinium). While this figure shows only some representative slices, the examination demonstrated 15 new lesions compared to the previous MRI nine months earlier.
See this image and copyright information in PMC

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