Rituximab for MS

    For this first blog, I wanted to tell you about a shadowing experience I’ve had. About two years ago I shadowed a physician assistant at the Denver Health Neurology clinic who was introduced to many things such as Multiple sclerosis (MS), migraines, and epilepsy. She usually had one day of the week where there were only MS patients where she would check up on them after infusions and see what they needed. MS is a chronic inflammatory disease of the central nervous system that causes lesions in the brain which can lead to neurologic dysfunction and other conditions, such as fatigue, pain, depression, and anxiety.

    One of the treatment options that she always recommended was an infusion called rituximab because it was effective and only had to be given every 6 to 9 months. Rituximab starts acting within a few days and its effect lasts for several months. Rituximab is a B-cell-depleting monoclonal antibody that is administered through an intravenous infusion. To understand rituximab, you need to know the function of B-cells. Their role in our bodies is to secrete antibodies, present antigen, and regulate the immune response by producing proinflammatory and anti-inflammatory cytokines. B-cells are part of the immune system. The way rituximab work is by “sticking” to b-cell and killing them. This lowers the b-cell count in the body and doesn’t allow the immune system to create more lesions in the brain. Current evidence suggests that MS is an autoimmune disorder of the central nervous system autoimmune disorder because it is the immune system that attacks and causes lesions. A fun fact about rituximab is that it was originally licensed to treat refractory rheumatoid arthritis. Throughout this experience, I was able to see how a clinic runs and learn about different diseases.


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Whittam DH, Tallantyre EC, Jolles S, Huda S, Moots RJ, Kim HJ, Robertson NP, Cree BAC, Jacob A.         Rituximab in neurological disease: principles, evidence and practice. Pract Neurol. 2019 Feb;19(1):5-            20.  Doi: 10.1136/practneurol-2018-001899. Epub2018 Nov 29. PMID: 30498056.