Multicenter Study Tracks Long-Term Rituximab Outcomes in Anti-MAG Neuropathy

More than one third of patients with anti-myelin-associated glycoprotein (MAG) neuropathy experienced long-term functional improvement following rituximab monotherapy in a multicenter retrospective study of 149 French patients. Over a mean follow-up of 4 years, ranging from 1 to 19 years, treatment success—defined as an improvement of at least 1 point in the Overall Neuropathy Limitation Scale (ONLS) score compared with baseline—was observed in 54 of 149 patients (36%) at the last follow-up. Among the patients who improved by their last follow-up, 92% had already demonstrated improvement 1 year after the first rituximab infusion.

The study cohort included patients with anti-MAG antibody titers exceeding 10,000 BTU, evaluating an intervention recognized as the most widely used treatment for anti-MAG neuropathy despite its efficacy not having been demonstrated in controlled trials. Assessment of clinical outcomes at intermediate intervals demonstrated ONLS improvement in 60 of 146 patients (41%) at 1 year and in 44 of 104 patients (42%) at 2 years post-infusion.

Shorter disease duration, lower monoclonal IgM levels, and an induction regimen of 1 g of rituximab administered on days 1 and 15 were associated with treatment response in the cohort. In contrast, repeated rituximab infusions were not associated with a higher response rate.

Subject of Research: Long-term outcomes of rituximab monotherapy in anti-MAG neuropathy

Article Title: Long-term outcomes and predictors of response to rituximab in anti-MAG neuropathy: a multicenter real-world study

Article References: Delmont, E., Cintas, P., Tard, C., Boucraut, J., Magy, L., Frachet, S., Labeyrie, C., Echaniz-Laguna, A., Noel, N., Svahn, J., Pegat, A., Bouhour, F., Cluse, F., Puma, A., Magot, A., Farnault, L., Schleinitz, T. A., Gendre, T., Planté-Bordeneuve, V., … Attarian, S. (2026). Long-term outcomes and predictors of response to rituximab in anti-MAG neuropathy: a multicenter real-world study. Journal of Neurology, 273(11), 702. https://doi.org/10.1007/s00415-026-14230-0

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DOI: 10.1007/s00415-026-14230-0

Keywords: rituximab, anti-MAG neuropathy, Overall Neuropathy Limitation Scale, retrospective study, multicenter study, monoclonal IgM, Journal of Neurology, neurology, Long-term, outcomes, predictors, response