Reply To: Anti-MAG treatment update

Below is the text from the article referenced by Sundayrush. Thanks for posting but I hope someone can explain why Medicare doesn’t approve or if they have received Rituxan through Medicare how you got it approved?

Annals of Hematology

June 2015, Volume 94, Issue 6, pp 1011–1016

IgM MGUS associated with anti-MAG neuropathy: a single institution experience

Authors
Authors and affiliations
Giampaolo TalamoEmail authorMuhammad A. MirManoj K. PandeyJeffrey K. SivikDivisha Raheja

Abstract

Anti-MAG neuropathy is a very rare form of acquired polyneuropathy associated with IgM monoclonal gammopathy of undetermined significance (MGUS). We conducted a retrospective review of 194 consecutive MGUS patients seen at the Penn State Hershey Cancer Institute. We identified six patients among 37 (16 %) with IgM MGUS with anti-MAG neuropathy. Interestingly, an additional patient had anti-MAG neuropathy without MGUS. Common clinical manifestations were numbness and paresthesias of the extremities and gait imbalance. All four patients treated with rituximab and none of the three untreated ones had a subjective improvement of their symptoms. We conclude that all patients with IgM MGUS and neuropathy should be screened for anti-MAG antibodies and, if positive, they should be offered treatment with rituximab.