research from Singapore… @Jonathan Edwards?
paywall for me.
https://www.jni-journal.com/article/S0165-5728(25)00039-6/abstract
Efficacy of rituximab on antibody-positive small fiber neuropathy: A series of 5 cases
Results
Two patients were positive for anti-TS-HDS, one for anti-plexin D1 and two for anti-FGFR3 antibodies. Therapeutic efficacy was assessed by circulating CD19+ B cell levels with flow cytometry. Clinical questionnaires, including Visual Analogue Scale (VAS), Rasch Transformed 13-item SFN Symptom Inventory Quotient (RT-SFN-SIQ), Small Fiber Neuropathy-specific Rasch-built overall disability scale (SFN-RODS) and the Composite Autonomic Symptom Scale (COMPASS-31) were obtained prior to rituximab infusion, and at 4 weeks and 4 months post-infusion. Significantly improved VAS was seen at 4 months after rituximab, while a trend towards improvement was seen in RT-SFN-SIQ, and SFN-RODS. COMPASS-31 score remained static.
Discussion
These five cases illustrate the clinical efficacy of rituximab in the treatment of anti-TS-HDS, anti-FGFR3-positive and anti-plexin D1 SFN. Our patients had the typical presentations of immune-mediated subtypes of SFN, i.e. majority were female patients with near normal neurological examination, presenting acutely with neuropathic pain, sensory impairment and autonomic disturbances. No patients had abnormal laboratory values that would suggest other causes of small fiber neuropathy.
paywall for me.
https://www.jni-journal.com/article/S0165-5728(25)00039-6/abstract
Efficacy of rituximab on antibody-positive small fiber neuropathy: A series of 5 cases
Results
Two patients were positive for anti-TS-HDS, one for anti-plexin D1 and two for anti-FGFR3 antibodies. Therapeutic efficacy was assessed by circulating CD19+ B cell levels with flow cytometry. Clinical questionnaires, including Visual Analogue Scale (VAS), Rasch Transformed 13-item SFN Symptom Inventory Quotient (RT-SFN-SIQ), Small Fiber Neuropathy-specific Rasch-built overall disability scale (SFN-RODS) and the Composite Autonomic Symptom Scale (COMPASS-31) were obtained prior to rituximab infusion, and at 4 weeks and 4 months post-infusion. Significantly improved VAS was seen at 4 months after rituximab, while a trend towards improvement was seen in RT-SFN-SIQ, and SFN-RODS. COMPASS-31 score remained static.
Discussion
These five cases illustrate the clinical efficacy of rituximab in the treatment of anti-TS-HDS, anti-FGFR3-positive and anti-plexin D1 SFN. Our patients had the typical presentations of immune-mediated subtypes of SFN, i.e. majority were female patients with near normal neurological examination, presenting acutely with neuropathic pain, sensory impairment and autonomic disturbances. No patients had abnormal laboratory values that would suggest other causes of small fiber neuropathy.
