Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Autoimmune encephalitides are severe neurological disorders requiring urgent treatment, even though there is no standard guideline by lack of empirical evidence. Commonly used treatments are divided into so-called first-line (steroids, intravenous immunoglobulins, plasma exchanges) and second-line (rituximab, cyclophosphamide, tocilizumab, others), and may be used in association or sequentially. There is no standard practice, and initial treatment protocol may consist in first-line alone, first-line with rituximab, or first-line with dual immunosuppression (rituximab and cyclophosphamide). Absence of clear response to initial treatment in the first 4 to 6 weeks may indicate undertreatment and is generally followed by treatment escalation, mostly to dual immunosuppression. However, as the frequency of non-responders to initial treatment is unknown, it is still unclear whether dual immunosuppression should be offered to all patients from inception.
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Label | Type | Description | Intervention Names |
|---|---|---|---|
| group 1 : Patients with NMDAR encephalitis | Patients with untreated anti-NMDAR encephalitis or with a decision to treat within the previous 30 days |
| |
| group 2 : Patients with GAD encephalitis | Patients with untreated anti-GAD encephalitis or with a decision to treat within the previous 30 days |
| |
| group 3 : Patients with LGI1 encephalitis | Patients with untreated anti-LGI1 encephalitis or with a decision to treat within the previous 30 days |
| |
| group 4 : Patients with IgLON5 encephalitis | Patients with untreated anti-IgLON5 encephalitis or with a decision to treat within the previous 30 days |
| |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| We aim to assess the clinical response to the treatment initiation protocols most commonly used in autoimmune encephalitis (first-line, first-line with rituximab, dual immunosuppression). | Other | The patients will be identified via the French Nationwide Multidisciplinary Team Meetings for Autoimmune encephalitis, which are conducted on a bi-monthly basis. All patients with newly diagnosed NMDAR, LGI1, CASPR2, IgLON5, GFAP or GAD65 encephalitis and treated for less than 8 weeks will be included. Treatment protocols at the initiation of therapy will be stratified into: 1) first-line only; 2) rituximab without cyclophosphamide; 3) rituximab combined with cyclophosphamide; 4) others. The referral clinicians will be contacted by email and the data will be collected using standardized questionnaires, which will be sent at baseline (visit 1, V1) and 4 months after the initiation of therapy (visit 2, V2). The questionnaires will be structured into 7 sections:
|
| Measure | Description | Time Frame |
|---|---|---|
| Failure of the initial treatment protocol | Failure of the initial treatment protocol, reflected by the decision to escalate treatment between V1 and V2. Treatment escalation is defined as the addition of one or more second-line treatments more than 30 days after the start of the initial treatment. | At baseline and 4 months after the initiation of therapy |
Not provided
Not provided
Inclusion Criteria:
Exclusion Criteria:
- Refusal by the referring doctor to participate or refusal by the patient mentioned in the objection to the use of his/her clinical data.
Not provided
Not provided
Not provided
Not provided
All Patients with autoimmune encephalitis defined anti-GAD NMDAR, LGI1, CASPR2, IgLON5 or GFAP and untreated within the previous 30 days
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Bastien Pr JOUBERT | Contact | 04 78 86 17 89 | bastien.joubert@chu-lyon.fr | |
| Géraldine PICARD | Contact | 04.72.35.58.42 | geraldine.picard@chu-lyon.fr |
Not provided
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hospices Civil de Lyon | Recruiting | Bron | 69677 | France |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
serum, DNA, CSF, PBMC
| group 5 : Patients with GFAP encephalitis |
Patients with untreated anti-GFAP encephalitis or with a decision to treat within the previous 30 days |
|
| group 6 : Patients with CASPR2 encephalitis | Patients with untreated anti-CASPR2 encephalitis or with a decision to treat within the previous 30 days |
|
|
| ID | Term |
|---|---|
| D020274 | Autoimmune Diseases of the Nervous System |
| ID | Term |
|---|---|
| D009422 | Nervous System Diseases |
| D001327 | Autoimmune Diseases |
| D007154 | Immune System Diseases |
Not provided
Not provided
| ID | Term |
|---|---|
| D000069283 | Rituximab |
| ID | Term |
|---|---|
| D058846 | Antibodies, Monoclonal, Murine-Derived |
| D000911 | Antibodies, Monoclonal |
| D000906 | Antibodies |
| D007136 | Immunoglobulins |
| D007162 | Immunoproteins |
| D001798 | Blood Proteins |
| D011506 | Proteins |
| D000602 | Amino Acids, Peptides, and Proteins |
| D012712 | Serum Globulins |
| D005916 | Globulins |
Not provided
Not provided