Treatment strategies for autoimmune encephalitis

Autoimmune encephalitis is one of the most rapidly growing research topics in neurology. Along with discoveries of novel antibodies associated with the disease, clinical experience and outcomes with diverse immunotherapeutic agents in the treatment of autoimmune encephalitis are accumulating. Retros...

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Published inTherapeutic advances in neurological disorders Vol. 11; p. 1756285617722347
Main Authors Shin, Yong-Won, Lee, Soon-Tae, Park, Kyung-Il, Jung, Keun-Hwa, Jung, Ki-Young, Lee, Sang Kun, Chu, Kon
Format Journal Article
LanguageEnglish
Published London, England SAGE Publications 01.01.2018
SAGE PUBLICATIONS, INC
SAGE Publishing
Subjects
Autoimmune diseases
Corticosteroids
Encephalitis
Immunotherapy
Monoclonal antibodies
Review
autoimmune encephalitis
immunotherapeutic agent
treatment option
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Abstract Autoimmune encephalitis is one of the most rapidly growing research topics in neurology. Along with discoveries of novel antibodies associated with the disease, clinical experience and outcomes with diverse immunotherapeutic agents in the treatment of autoimmune encephalitis are accumulating. Retrospective observations indicate that early aggressive treatment is associated with better functional outcomes and fewer relapses. Immune response to first-line immunotherapeutic agents (corticosteroids, intravenous immunoglobulin, plasma exchange, and immunoadsorption) is fair, but approximately half or more of patients are administered second-line immunotherapy (rituximab and cyclophosphamide). A small but significant proportion of patients are refractory to all first- and second-line therapies and require further treatment. Although several investigations have shown promising alternatives, the low absolute number of patients involved necessitates more evidence to establish further treatment strategies. In this review, the agents used for first- and second-line immunotherapy are discussed and recent attempts at finding new treatment options are introduced.
AbstractList Autoimmune encephalitis is one of the most rapidly growing research topics in neurology. Along with discoveries of novel antibodies associated with the disease, clinical experience and outcomes with diverse immunotherapeutic agents in the treatment of autoimmune encephalitis are accumulating. Retrospective observations indicate that early aggressive treatment is associated with better functional outcomes and fewer relapses. Immune response to first-line immunotherapeutic agents (corticosteroids, intravenous immunoglobulin, plasma exchange, and immunoadsorption) is fair, but approximately half or more of patients are administered second-line immunotherapy (rituximab and cyclophosphamide). A small but significant proportion of patients are refractory to all first- and second-line therapies and require further treatment. Although several investigations have shown promising alternatives, the low absolute number of patients involved necessitates more evidence to establish further treatment strategies. In this review, the agents used for first- and second-line immunotherapy are discussed and recent attempts at finding new treatment options are introduced.
Autoimmune encephalitis is one of the most rapidly growing research topics in neurology. Along with discoveries of novel antibodies associated with the disease, clinical experience and outcomes with diverse immunotherapeutic agents in the treatment of autoimmune encephalitis are accumulating. Retrospective observations indicate that early aggressive treatment is associated with better functional outcomes and fewer relapses. Immune response to first-line immunotherapeutic agents (corticosteroids, intravenous immunoglobulin, plasma exchange, and immunoadsorption) is fair, but approximately half or more of patients are administered second-line immunotherapy (rituximab and cyclophosphamide). A small but significant proportion of patients are refractory to all first- and second-line therapies and require further treatment. Although several investigations have shown promising alternatives, the low absolute number of patients involved necessitates more evidence to establish further treatment strategies. In this review, the agents used for first- and second-line immunotherapy are discussed and recent attempts at finding new treatment options are introduced.Autoimmune encephalitis is one of the most rapidly growing research topics in neurology. Along with discoveries of novel antibodies associated with the disease, clinical experience and outcomes with diverse immunotherapeutic agents in the treatment of autoimmune encephalitis are accumulating. Retrospective observations indicate that early aggressive treatment is associated with better functional outcomes and fewer relapses. Immune response to first-line immunotherapeutic agents (corticosteroids, intravenous immunoglobulin, plasma exchange, and immunoadsorption) is fair, but approximately half or more of patients are administered second-line immunotherapy (rituximab and cyclophosphamide). A small but significant proportion of patients are refractory to all first- and second-line therapies and require further treatment. Although several investigations have shown promising alternatives, the low absolute number of patients involved necessitates more evidence to establish further treatment strategies. In this review, the agents used for first- and second-line immunotherapy are discussed and recent attempts at finding new treatment options are introduced.
Author Lee, Soon-Tae
Shin, Yong-Won
Lee, Sang Kun
Park, Kyung-Il
Jung, Keun-Hwa
Jung, Ki-Young
Chu, Kon
Author_xml – sequence: 1
  givenname: Yong-Won
  surname: Shin
  fullname: Shin, Yong-Won
  organization: Department of Neurology, Comprehensive Epilepsy Center, Laboratory for Neurotherapeutics, Biomedical Research Institute, Seoul National University Hospital, Seoul, South Korea Program in Neuroscience, Seoul National University College of Medicine, Seoul, South Korea Yeongjusi Health Center, Gyeongsangbuk-do, South Korea
– sequence: 2
  givenname: Soon-Tae
  surname: Lee
  fullname: Lee, Soon-Tae
  organization: Department of Neurology, Comprehensive Epilepsy Center, Laboratory for Neurotherapeutics, Biomedical Research Institute, Seoul National University Hospital, Seoul, South Korea Program in Neuroscience, Seoul National University College of Medicine, Seoul, South Korea
– sequence: 3
  givenname: Kyung-Il
  surname: Park
  fullname: Park, Kyung-Il
  organization: Department of Neurology, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, South Korea
– sequence: 4
  givenname: Keun-Hwa
  surname: Jung
  fullname: Jung, Keun-Hwa
  organization: Department of Neurology, Comprehensive Epilepsy Center, Laboratory for Neurotherapeutics, Biomedical Research Institute, Seoul National University Hospital, Seoul, South Korea Program in Neuroscience, Seoul National University College of Medicine, Seoul, South Korea
– sequence: 5
  givenname: Ki-Young
  surname: Jung
  fullname: Jung, Ki-Young
  organization: Department of Neurology, Comprehensive Epilepsy Center, Laboratory for Neurotherapeutics, Biomedical Research Institute, Seoul National University Hospital, Seoul, South Korea Program in Neuroscience, Seoul National University College of Medicine, Seoul, South Korea
– sequence: 6
  givenname: Sang Kun
  surname: Lee
  fullname: Lee, Sang Kun
  organization: Department of Neurology, Comprehensive Epilepsy Center, Laboratory for Neurotherapeutics, Biomedical Research Institute, Seoul National University Hospital, Seoul, South Korea Program in Neuroscience, Seoul National University College of Medicine, Seoul, South Korea
– sequence: 7
  givenname: Kon
  surname: Chu
  fullname: Chu, Kon
  organization: Department of Neurology, Comprehensive Epilepsy Center, Laboratory for Neurotherapeutics, Biomedical Research Institute, Seoul National niversity Hospital, 101, Daehangno, Jongno-gu, Seoul 110-744, South Korea Program in Neuroscience, Seoul National University College of Medicine, Seoul, South Korea
BackLink https://www.ncbi.nlm.nih.gov/pubmed/29399043$$D View this record in MEDLINE/PubMed
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Keywords autoimmune encephalitis
immunotherapeutic agent
treatment option
Language English
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Snippet Autoimmune encephalitis is one of the most rapidly growing research topics in neurology. Along with discoveries of novel antibodies associated with the...
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StartPage 1756285617722347
SubjectTerms Autoimmune diseases
Corticosteroids
Encephalitis
Immunotherapy
Monoclonal antibodies
Review
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Title Treatment strategies for autoimmune encephalitis
URI https://journals.sagepub.com/doi/full/10.1177/1756285617722347
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Volume 11
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