, Annexe 2. : Serment d'Hippocrate Au moment d'être admis à exercer la médecine, je promets et je jure d'être fidèle aux lois de l'honneur et de la probité

, Mon premier souci sera de rétablir, de préserver ou de promouvoir la santé dans tous ses éléments, physiques et mentaux, individuels et sociaux

, Je respecterai toutes les personnes, leur autonomie et leur volonté, sans aucune discrimination selon leur état ou leurs convictions. J'interviendrai pour les protéger si elles sont affaiblies, vulnérables ou menacées dans leur intégrité ou leur dignité. Même sous la contrainte

, Admis dans l'intimité des personnes, je tairai les secrets qui me seront confiés

, J'apporterai mon aide à mes confrères ainsi qu'à leurs familles dans l'adversité

, Que les hommes et mes confrères m'accordent leur estime si je suis fidèle à mes promesses

E. Devic, Myélite subaiguë compliquée de névrite optique, Bull Med, vol.8, pp.1033-1037, 1894.

F. Gault, De la neuromyélite optique aiguë, Thèse de médecine. Faculté de Médecine et de Pharmacie de Lyon, 1894.

R. N. Mandler, L. E. Davis, D. R. Jeffery, and M. Kornfeld, Devic's neuromyelitis optica: a clinicopathological study of 8 patients, Ann Neurol. août, vol.34, issue.2, pp.162-170, 1993.

J. I. O'riordan, H. L. Gallagher, A. J. Thompson, R. S. Howard, D. P. Kingsley et al., Clinical, CSF, and MRI findings in Devic's neuromyelitis optica, J Neurol Neurosurg Psychiatry. avr, vol.60, issue.4, pp.382-389, 1996.

D. M. Wingerchuk, W. F. Hogancamp, P. C. O'brien, and B. G. Weinshenker, The clinical course of neuromyelitis optica (Devic's syndrome), Neurology. sept, vol.53, issue.5, pp.1107-1121, 1999.

V. A. Lennon, D. M. Wingerchuk, T. J. Kryzer, S. J. Pittock, C. F. Lucchinetti et al., A serum autoantibody marker of neuromyelitis optica: distinction from multiple sclerosis, Lancet Lond Engl. déc, vol.364, issue.9451, pp.2106-2118, 2004.

D. M. Wingerchuk, V. A. Lennon, S. J. Pittock, C. F. Lucchinetti, and B. G. Weinshenker, Revised diagnostic criteria for neuromyelitis optica, Neurology. mai, vol.66, issue.10, pp.1485-1494, 2006.

D. M. Wingerchuk, B. Banwell, J. L. Bennett, P. Cabre, W. Carroll et al., International consensus diagnostic criteria for neuromyelitis optica spectrum disorders, Neurology. juill, vol.85, issue.2, pp.177-89, 2015.

S. Jarius and B. Wildemann, AQP4 antibodies in neuromyelitis optica: diagnostic and pathogenetic relevance, Nat Rev Neurol. juill, vol.6, issue.7, pp.383-92, 2010.

S. Jarius and B. Wildemann, Aquaporin-4 antibodies (NMO-IgG) as a serological marker of neuromyelitis optica: a critical review of the literature, Brain Pathol Zurich Switz, vol.23, issue.6, pp.661-83, 2013.

S. Hamid, D. Whittam, K. Mutch, S. Linaker, T. Solomon et al., What proportion of AQP4-IgG-negative NMO spectrum disorder patients are MOG-IgG positive? A cross sectional study of 132 patients, J Neurol, vol.264, issue.10, pp.2088-94, 2017.

J. Kitley, M. Woodhall, P. Waters, M. I. Leite, E. Devenney et al., Myelin-oligodendrocyte glycoprotein antibodies in adults with a neuromyelitis optica phenotype, Neurology. sept, vol.79, issue.12, pp.1273-1280, 2012.

A. Pröbstel, R. G. Dornmair, K. Collongues, N. Chanson, J. Sanderson et al., Anti-MOG antibodies are present in a subgroup of patients with a neuromyelitis optica phenotype, J Neuroinflammation. mars, vol.12, p.46, 2015.

M. Etemadifar, Z. Nasr, B. Khalili, M. Taherioun, and R. Vosoughi, Epidemiology of neuromyelitis optica in the world: a systematic review and meta-analysis, Mult Scler Int. avr, p.174720, 2015.

M. A. Mealy, D. M. Wingerchuk, B. M. Greenberg, and M. Levy, Epidemiology of neuromyelitis optica in the United States: a multicenter analysis, Arch Neurol. sept, vol.69, issue.9, pp.1176-80, 2012.

J. Badaut, F. Lasbennes, P. J. Magistretti, and L. Regli, Aquaporins in brain: distribution, physiology, and pathophysiology, J Cereb Blood Flow Metab Off J Int Soc Cereb Blood Flow Metab. avr, vol.22, issue.4, pp.367-78, 2002.

M. Zelenina, Regulation of brain aquaporins, Neurochem Int, vol.57, issue.4, pp.468-88, 2010.

C. F. Lucchinetti, R. N. Mandler, D. Mcgavern, W. Bruck, G. Gleich et al., A role for humoral mechanisms in the pathogenesis of Devic's neuromyelitis optica, Brain J Neurol. juill, vol.125, pp.1450-61, 2002.

S. R. Hinson, M. F. Romero, B. Popescu, C. F. Lucchinetti, J. P. Fryer et al., Molecular outcomes of neuromyelitis optica (NMO)-IgG binding to aquaporin-4 in astrocytes, Proc Natl Acad Sci, vol.109, issue.4, pp.1245-50, 2012.

C. F. Lucchinetti, Y. Guo, B. Popescu, K. Fujihara, Y. Itoyama et al., The Pathology of an Autoimmune Astrocytopathy: Lessons Learned from Neuromyelitis Optica, Brain Pathol. janv, vol.24, issue.1, pp.83-97, 2014.

P. J. Waters, A. Mckeon, M. I. Leite, S. Rajasekharan, V. A. Lennon et al., Serologic diagnosis of NMO: a multicenter comparison of aquaporin-4-IgG assays, Neurology. 28 févr, vol.78, issue.9, pp.665-671, 2012.

E. P. Flanagan, P. Cabre, B. G. Weinshenker, J. S. Sauver, D. J. Jacobson et al., Epidemiology of aquaporin-4 autoimmunity and neuromyelitis optica spectrum, Ann Neurol. mai, vol.79, issue.5, pp.775-83, 2016.

Y. Yang, D. Huang, W. Wu, L. Wu, L. Chen et al., The role of aquaporin-4 antibodies in Chinese patients with neuromyelitis optica, J Clin Neurosci Off J Neurosurg Soc Australas. janv, vol.20, issue.1, pp.94-102, 2013.

S. Jarius, K. Ruprecht, B. Wildemann, T. Kuempfel, M. Ringelstein et al., Contrasting disease patterns in seropositive and seronegative neuromyelitis optica: A multicentre study of 175 patients, J Neuroinflammation. janv, vol.9, p.14, 2012.

Y. Jiao, J. P. Fryer, V. A. Lennon, A. Mckeon, S. M. Jenkins et al., Aquaporin 4 IgG serostatus and outcome in recurrent longitudinally extensive transverse myelitis, JAMA Neurol. janv, vol.71, issue.1, pp.48-54, 2014.

B. G. Weinshenker, D. M. Wingerchuk, S. Vukusic, L. Linbo, S. J. Pittock et al., Neuromyelitis optica IgG predicts relapse after longitudinally extensive transverse myelitis, Ann Neurol. mars, vol.59, issue.3, pp.566-575, 2006.

N. Collongues, R. Marignier, H. Zéphir, C. Papeix, F. Blanc et al., Neuromyelitis optica in France: a multicenter study of 125 patients, Neurology. mars, vol.74, issue.9, pp.736-778, 2010.

R. Takano, T. Misu, T. Takahashi, S. Sato, K. Fujihara et al., Astrocytic damage is far more severe than demyelination in NMO: a clinical CSF biomarker study, Neurology. juill, vol.75, issue.3, pp.208-224, 2010.

D. K. Sato, D. Callegaro, F. M. De-haidar-jorge, I. Nakashima, S. Nishiyama et al., Cerebrospinal Fluid Aquaporin-4 Antibody Levels in Neuromyelitis Optica Attacks, Ann Neurol. août, vol.76, issue.2, pp.305-314, 2014.

N. Lin, Q. Liu, X. Wang, J. Ma, and Y. Li, Role of AQP4 Antibody Serostatus and its Prediction of Visual Outcome in Neuromyelitis Optica: A Systematic Review and Meta-Analysis, Protein Pept Lett, vol.24, issue.3, pp.245-52, 2017.

J. Kitley, M. I. Leite, I. Nakashima, P. Waters, B. Mcneillis et al., Prognostic factors and disease course in aquaporin-4 antibody-positive patients with neuromyelitis optica spectrum disorder from the United Kingdom and Japan, Brain J Neurol. juin, vol.135, pp.1834-1883, 2012.

H. J. Schluesener, R. A. Sobel, C. Linington, and H. L. Weiner, A monoclonal antibody against a myelin oligodendrocyte glycoprotein induces relapses and demyelination in central nervous system autoimmune disease, J Immunol Baltim Md, vol.139, issue.12, pp.4016-4037, 1950.

P. Peschl, M. Bradl, R. Höftberger, T. Berger, and M. Reindl, Myelin Oligodendrocyte Glycoprotein: Deciphering a Target in Inflammatory Demyelinating Diseases, Front Immunol. mai, vol.8, p.529, 2017.

D. Pham-dinh, M. G. Mattei, J. L. Nussbaum, G. Roussel, P. Pontarotti et al., Myelin/oligodendrocyte glycoprotein is a member of a subset of the immunoglobulin superfamily encoded within the major histocompatibility complex, Proc Natl Acad Sci, vol.90, issue.17, pp.7990-7994, 1993.

M. V. Gardinier, P. Amiguet, C. Linington, and J. M. Matthieu, Myelin/oligodendrocyte glycoprotein is a unique member of the immunoglobulin superfamily, J Neurosci Res. sept, vol.33, issue.1, pp.177-87, 1992.

M. Reindl, C. Linington, U. Brehm, R. Egg, E. Dilitz et al., Antibodies against the myelin oligodendrocyte glycoprotein and the myelin basic protein in multiple sclerosis and other neurological diseases: a comparative study, Brain J Neurol, vol.122, pp.2047-56, 1999.

A. Karni, R. Bakimer-kleiner, O. Abramsky, and A. Ben-nun, Elevated levels of antibody to myelin oligodendrocyte glycoprotein is not specific for patients with multiple sclerosis, Arch Neurol. mars, vol.56, issue.3, pp.311-316, 1999.

M. Markovic, V. Trajkovic, J. Drulovic, S. Mesaros, N. Stojsavljevic et al., Antibodies against myelin oligodendrocyte glycoprotein in the cerebrospinal fluid of multiple sclerosis patients, J Neurol Sci. juill, vol.211, issue.1-2, pp.67-73, 2003.

S. Gaertner, K. L. De-graaf, B. Greve, and R. Weissert, Antibodies against glycosylated native MOG are elevated in patients with multiple sclerosis, Neurology. déc, vol.63, issue.12, pp.2381-2384, 2004.

E. Mathey, C. Breithaupt, A. S. Schubart, and C. Linington, Commentary: Sorting the wheat from the chaff: identifying demyelinating components of the myelin oligodendrocyte glycoprotein (MOG)-specific autoantibody repertoire, Eur J Immunol. août, vol.34, issue.8, pp.2065-71, 2004.

C. B. Marta, A. R. Oliver, R. A. Sweet, S. E. Pfeiffer, and N. H. Ruddle, Pathogenic myelin oligodendrocyte glycoprotein antibodies recognize glycosylated epitopes and perturb oligodendrocyte physiology, Proc Natl Acad Sci, vol.102, issue.39, pp.13992-13999, 2005.

A. Cobo-calvo, A. Ruiz, E. Maillart, B. Audoin, H. Zephir et al., Clinical spectrum and prognostic value of CNS MOG autoimmunity in adults: The MOGADOR study, Neurology. mai, vol.90, issue.21, pp.1858-69, 2018.
URL : https://hal.archives-ouvertes.fr/hal-01919569

S. Mader, V. Gredler, K. Schanda, K. Rostasy, I. Dujmovic et al., Complement activating antibodies to myelin oligodendrocyte glycoprotein in neuromyelitis optica and related disorders, J Neuroinflammation. déc, vol.8, p.184, 2011.

S. Jarius, K. Ruprecht, I. Kleiter, N. Borisow, N. Asgari et al., MOG-IgG in NMO and related disorders: a multicenter study of 50 patients. Part 1: Frequency, syndrome specificity, influence of disease activity, long-term course, association with AQP4-IgG, and origin, J Neuroinflammation. sept, vol.13, issue.1, p.279, 2016.

F. Brilot, R. C. Dale, R. C. Selter, V. Grummel, S. R. Kalluri et al., Antibodies to native myelin oligodendrocyte glycoprotein in children with inflammatory demyelinating central nervous system disease, Ann Neurol. déc, vol.66, issue.6, pp.833-875, 2009.

S. Salama, M. Khan, S. Pardo, I. Izbudak, and M. Levy, MOG antibody-associated encephalomyelitis/encephalitis, Mult Scler. mars, p.1352458519837705, 2019.

M. Jurynczyk, S. Messina, M. R. Woodhall, N. Raza, R. Everett et al., Clinical presentation and prognosis in MOG-antibody disease: a UK study, Brain J Neurol. déc, vol.140, issue.12, pp.3128-3166, 2017.

C. Alves-do-rego and N. Collongues, Neuromyelitis optica spectrum disorders: Features of aquaporin-4, myelin oligodendrocyte glycoprotein and double-seronegative-mediated subtypes, Rev Neurol (Paris). juin, vol.174, issue.6, pp.458-70, 2018.

D. K. Sato, D. Callegaro, L. , M. A. Waters, P. J. De-haidar-jorge et al., Distinction between MOG antibody-positive and AQP4 antibody-positive NMO spectrum disorders, Neurology. févr, vol.82, issue.6, pp.474-81, 2014.

E. D. Van-pelt, Y. Wong, I. A. Ketelslegers, D. Hamann, and R. Q. Hintzen, Neuromyelitis optica spectrum disorders: comparison of clinical and magnetic resonance imaging characteristics of AQP4-IgG versus MOG-IgG seropositive cases in the Netherlands, Eur J Neurol. mars, vol.23, issue.3, pp.580-587, 2016.

M. Nakamura, T. Nakazawa, H. Doi, T. Hariya, K. Omodaka et al., Early high-dose intravenous methylprednisolone is effective in preserving retinal nerve fiber layer thickness in patients with neuromyelitis optica, Graefes Arch Clin Exp Ophthalmol. déc, vol.248, issue.12, pp.1777-85, 2010.

N. Collongues and J. De-seze, Current and future treatment approaches for neuromyelitis optica, Ther Adv Neurol Disord. mars, vol.4, issue.2, pp.111-132, 2011.

M. Bonnan and P. Cabre, Plasma exchange in severe attacks of neuromyelitis optica, Mult Scler Int. fevr, vol.2012, p.787630, 2012.

I. Kleiter, A. Gahlen, N. Borisow, K. Fischer, K. Wernecke et al., Neuromyelitis optica: Evaluation of 871 attacks and 1,153 treatment courses, Ann Neurol. févr, vol.79, issue.2, pp.206-222, 2016.

M. Bonnan, R. Valentino, S. Debeugny, H. Merle, J. Fergé et al., Short delay to initiate plasma exchange is the strongest predictor of outcome in severe attacks of NMO spectrum disorders, J Neurol Neurosurg Psychiatry, vol.89, issue.4, pp.346-51, 2018.

H. M. Reeves and J. L. Winters, The mechanisms of action of plasma exchange, Br J Haematol. févr, vol.164, issue.3, pp.342-51, 2014.

L. Elsone, J. Panicker, K. Mutch, M. Boggild, R. Appleton et al., Role of intravenous immunoglobulin in the treatment of acute relapses of neuromyelitis optica: experience in 10 patients, Mult Scler. avr, vol.20, issue.4, pp.501-505, 2014.

S. Watanabe, T. Misu, I. Miyazawa, I. Nakashima, Y. Shiga et al., Low-dose corticosteroids reduce relapses in neuromyelitis optica: a retrospective analysis, Mult Scler. sept, vol.13, issue.8, pp.968-74, 2007.

S. J. Pittock, A. Berthele, K. Fujihara, H. J. Kim, M. Levy et al., Eculizumab in Aquaporin-4-Positive Neuromyelitis Optica Spectrum Disorder, N Engl J Med. mai, 2019.

M. Ringelstein, I. Ayzenberg, J. Harmel, A. Lauenstein, E. Lensch et al., Long-term Therapy With Interleukin 6 Receptor Blockade in Highly Active Neuromyelitis Optica Spectrum Disorder, JAMA Neurol. juill, vol.72, issue.7, pp.756-63, 2015.

N. Collongues and J. De-seze, An update on the evidence for the efficacy and safety of rituximab in the management of neuromyelitis optica, Ther Adv Neurol Disord. mai, vol.9, issue.3, pp.180-188, 2016.

H. Zéphir, R. Bernard-valnet, C. Lebrun, O. Outteryck, B. Audoin et al., Rituximab as first-line therapy in neuromyelitis optica: efficiency and tolerability, J Neurol, vol.262, issue.10, pp.2329-2364, 2015.

N. Collongues, D. Brassat, E. Maillart, P. Labauge, J. C. Ouallet et al., Efficacy of rituximab in refractory neuromyelitis optica, Mult Scler. juin, vol.22, issue.7, pp.955-964, 2016.
URL : https://hal.archives-ouvertes.fr/hal-01889926

J. Ciron, B. Audoin, B. Bourre, D. Brassat, F. Durand-dubief et al., Recommendations for the use of Rituximab in neuromyelitis optica spectrum disorders, Rev Neurol (Paris). avr, vol.174, issue.4, pp.255-64, 2018.

R. F. Van-vollenhoven, R. M. Fleischmann, D. E. Furst, S. Lacey, and P. B. Lehane, Longterm Safety of Rituximab: Final Report of the Rheumatoid Arthritis Global Clinical Trial Program over 11 Years, J Rheumatol, vol.42, issue.10, pp.1761-1767, 2015.

D. B. Clifford, B. Ances, C. Costello, S. Rosen-schmidt, M. Andersson et al., Rituximabassociated progressive multifocal leukoencephalopathy in rheumatoid arthritis, Arch Neurol. sept, vol.68, issue.9, pp.1156-64, 2011.

V. Damato, A. Evoli, and R. Iorio, Efficacy and Safety of Rituximab Therapy in Neuromyelitis Optica Spectrum Disorders: A Systematic Review and Meta-analysis, JAMA Neurol, vol.73, issue.11, pp.1342-1350, 2016.

P. Cabre, M. Mejdoubi, S. Jeannin, H. Merle, Y. Plumelle et al., Treatment of neuromyelitis optica with rituximab: a 2-year prospective multicenter study, J Neurol. avr, vol.265, issue.4, pp.917-942, 2018.

Z. Nikoo, S. Badihian, V. Shaygannejad, N. Asgari, and F. Ashtari, Comparison of the efficacy of azathioprine and rituximab in neuromyelitis optica spectrum disorder: a randomized clinical trial, J Neurol. sept, vol.264, issue.9, pp.2003-2012, 2017.

A. Montcuquet, N. Collongues, C. Papeix, H. Zephir, B. Audoin et al., Effectiveness of mycophenolate mofetil as first-line therapy in AQP4-IgG, MOG-IgG, and seronegative neuromyelitis optica spectrum disorders, Mult Scler. sept, vol.23, issue.10, pp.1377-84, 2017.
URL : https://hal.archives-ouvertes.fr/hal-01798528

Y. Yang, C. Wang, B. Wang, Z. Zeng, and S. Guo, Comparison of efficacy and tolerability of azathioprine, mycophenolate mofetil, and lower dosages of rituximab among patients with neuromyelitis optica spectrum disorder, J Neurol Sci. fevr, vol.385, pp.192-199, 2018.

J. Lin, X. Li, B. Xue, Q. Tong, Z. Chen et al., Low-dosage of rituximab in Chinese patients with neuromyelitis optica spectrum disorder, J Neuroimmunol. avr, vol.317, pp.1-4, 2018.

C. Yang, Y. L. Li, T. Zhang, D. , J. Li et al., Responsiveness to reduced dosage of rituximab in Chinese patients with neuromyelitis optica, Neurology. août, vol.81, issue.8, pp.710-713, 2013.

M. Cohen, G. Romero, J. Bas, M. Ticchioni, M. Rosenthal et al., Monitoring CD27+ memory B-cells in neuromyelitis optica spectrum disorders patients treated with rituximab: Results from a bicentric study, J Neurol Sci. févr, vol.373, pp.335-343, 2017.

S. Jarius, K. Ruprecht, I. Kleiter, N. Borisow, N. Asgari et al., MOG-IgG in NMO and related disorders: a multicenter study of 50 patients. Part 2: Epidemiology, clinical presentation, radiological and laboratory features, treatment responses, and long-term outcome, J Neuroinflammation. sept, vol.13, issue.1, p.280, 2016.

S. Ramanathan, S. W. Reddel, A. Henderson, J. Parratt, M. Barnett et al., Antibodies to myelin oligodendrocyte glycoprotein in bilateral and recurrent optic neuritis, Neurol Neuroimmunol Neuroinflammation. déc, vol.1, issue.4, p.40, 2014.

M. Jury?czyk, A. Jacob, K. Fujihara, and J. Palace, Myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease: practical considerations, Pract Neurol. juin, vol.19, issue.3, pp.187-95, 2019.

S. Dass, A. C. Rawstron, E. M. Vital, K. Henshaw, D. Mcgonagle et al., Highly sensitive B cell analysis predicts response to rituximab therapy in rheumatoid arthritis, Arthritis Rheum, vol.58, issue.10, pp.2993-3002, 2008.

B. Brochet, Assessing incapacity at early stages of Multiple sclerosis using the EDSS, Rev Neurol, vol.165, issue.4, pp.173-179, 2009.

F. Gao, B. Chai, C. Gu, R. Wu, T. Dong et al., Effectiveness of rituximab in neuromyelitis optica: a meta-analysis, BMC Neurol. mars, vol.19, issue.1, p.36, 2019.

A. Cobo-calvo, M. Sepúlveda, F. Rollot, T. Armangué, A. Ruiz et al., Evaluation of treatment response in adults with relapsing MOG-Ab-associated disease, J Neuroinflammation. juill, vol.16, issue.1, p.134, 2019.
URL : https://hal.archives-ouvertes.fr/hal-02180590

S. Ramanathan, S. Mohammad, E. Tantsis, T. K. Nguyen, V. Merheb et al., Clinical course, therapeutic responses and outcomes in relapsing MOG antibody-associated demyelination, J Neurol Neurosurg Psychiatry, vol.89, issue.2, pp.127-164, 2018.

Y. Hacohen, Y. Y. Wong, C. Lechner, M. Jurynczyk, S. Wright et al., Disease Course and Treatment Responses in Children With Relapsing Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease, JAMA Neurol. avr, vol.75, issue.4, pp.478-87, 2018.

S. Kim, J. Hyun, A. Joung, S. H. Lee, and H. J. Kim, Occurrence of Asymptomatic Acute Neuromyelitis Optica Spectrum Disorder-Typical Brain Lesions during an Attack of Optic Neuritis or Myelitis, PLoS ONE. déc, issue.12, p.11, 2016.

A. Cobo-calvo, M. Sepúlveda, H. Indy, T. Armangué, A. Ruiz et al., Usefulness of MOG-antibody titres at first episode to predict the future clinical course in adults, J Neurol. avr, vol.266, issue.4, pp.806-821, 2019.

R. Hohlfeld, B-cells as therapeutic targets in neuro-inflammatory diseases, Clin Immunol Orlando Fla. janv, vol.186, pp.51-54, 2018.

J. W. Lindsey, K. M. Meulmester, S. A. Brod, F. Nelson, and J. S. Wolinsky, Variable results after rituximab in neuromyelitis optica, J Neurol Sci. juin, vol.317, issue.1-2, pp.103-108, 2012.

P. J. Mease, D. A. Revicki, J. Szechinski, M. Greenwald, A. Kivitz et al., Improved health-related quality of life for patients with active rheumatoid arthritis receiving rituximab: Results of the Dose-Ranging Assessment: International Clinical Evaluation of Rituximab in Rheumatoid Arthritis (DANCER) Trial, J Rheumatol. janv, vol.35, issue.1, pp.20-30, 2008.

J. S. Smolen, E. C. Keystone, P. Emery, F. C. Breedveld, N. Betteridge et al., Consensus statement on the use of rituximab in patients with rheumatoid arthritis, Ann Rheum Dis. févr, vol.66, issue.2, pp.143-50, 2007.

P. Emery, R. Fleischmann, A. Filipowicz-sosnowska, J. Schechtman, L. Szczepanski et al., The efficacy and safety of rituximab in patients with active rheumatoid arthritis despite methotrexate treatment: results of a phase IIB randomized, double-blind, placebo-controlled, dose-ranging trial, Arthritis Rheum. mai, vol.54, issue.5, pp.1390-400, 2006.

E. ,

, RTX)) a montré son efficacité sur la prévention des récidives des poussées et la diminution du handicap dans le spectre des neuromyélites optiques (NMOSD), en particulier dans les formes séropositives pour les anticorps anti, p.4

, Dans les maladies associées aux anti-« Myelin oligodendrocyte glycoprotein » (MOGAD), il n'existe pas de consensus sur le traitement de fond et l'efficacité des anti-CD20 est débattue

. Objectif, Premièrement, l'objectif est de comparer l'efficacité clinique du RTX sur le risque de poussée et la diminution du handicap chez les NMOSD AQP4+ et les MOGAD. Deuxièmement, l'objectif est d'étudier l'efficacité d

. Méthode, Il s'agit d'une étude rétrospective multicentrique d'une population de patients adultes NMOSD (AQP4+, MOG+ et double séronégatifs) en Nouvelle-Aquitaine. Le critère de jugement principal était de comparer le délai de survenue d'une poussée après le début du RTX entre le groupe NMOSD AQP4+ et MOGAD, à l'aide d'une analyse de survie. Les critères secondaires étaient l'évolution du taux annuel de poussée (TAP) et de l' « Expanded disability status scale » (EDSS) en fonction du sous-type d'anticorps

. Résultats, A 1 an et à 2 ans de suivi, il existait respectivement 94,1% et 69% de patients libres de poussée dans le groupe AQP4+; 84% et 66,7% dans le groupe MOG+. Dans le groupe MOGAD, le TAP moyen diminue significativement après le début du RTX (TAP l'année précédente à 1,95, comparativement au TAP la première année à 0,16, et la deuxième année à 0,30). Les MOGAD améliorent également leur handicap lors du suivi avec une diminution de l'EDSS. Concernant l'efficacité des corticoïdes, il n'existe pas de différence significative sur le délai de survenue d, Quarante et un patients NMOSD ont été inclus : 17 AQP4 +, 19 MOG+ et 5 double séronégatifs

, Conclusion. L'efficacité clinique du RTX en termes de prévention de poussée et de diminution du handicap n'était pas différente chez les patients du groupe NMOSD AQP4+ et du groupe MOGAD dans notre étude

, Nos résultats suggèrent également l'absence d'efficacité d'une corticothérapie adjuvante au RTX sur le risque de poussée en début de traitement chez les patients NMOSD

, Thèse de doctorant en médecine, spécialité Neurologie Mots clés : Neuromyelitis optica spectrum disorder (NMOSD), Maladies associées aux anti-MOG, RITUXIMAB, Anticorps anti-aquaporine 4