Question:

When is Bortezomib (Velcade) treatment used? 

Answer:

Bortezomib, a type of cancer treatment drug,  it is a plasma-cell-depleting proteasome inhibitor.

Proteasomes are in cells. They help to break down proteins that the cell doesn’t need. Bortezomib blocks the proteasomes so the proteins build up inside the cell. The cell then dies.  Cell death is called apoptosis (cell suicide).

When a patient with a severe case of autoimmune encephalitis,  is resistant to responding to treatment,  this is called ‘refractory’ to the treatment, the doctor may consider using Bortezomib. Bortezomib is considered when the patient is refractory to Rituxan/Rituximab a standard immunosuppressive and B-cell-depleting drug. 

Studies have shown Bortezomib as a promising escalation treatment that has had clinical improvement or disease remission is such cases, and with noted success in anti-NMDAr encephalitis.