Does Rituximab Reduce Relapse Risk in Anti-NMDAR Encephalitis?

Anti-NMDAR antibody–mediated encephalitis is a leading cause of autoimmune encephalitis, and up to 16% of patients experience a relapse. To evaluate the effect of rituximab, a second-line, B-cell depleting therapy, on relapse prevention, investigators retrospectively assessed a cohort of 67 adults seen at 10 Australian hospitals, of whom 47 patients received second-line therapy, all with rituximab, a median of 58 days after symptom onset. The investigators analyzed relapses during rituximab-exposed and unexposed periods.

A single course of rituximab was associated with a significant, 89% reduction in relapse risk (hazard ratio, 0.11). In patients considered for additional rituximab doses, rituximab remained protective for up to 6 months (HR,…