EFFICACY OF SECOND-LINE TREATMENT IN PATIENTS WITH AUTOIMMUNE ENCEPHALITIS

Abstract

Autoimmune encephalitis is one of the fastest-growing fields of research in neurology. With the identification of new antibodies related to the disease, clinical experience and knowledge about the efficacy of different immunotherapeutic agents in its treatment are also growing. This review aims to explore the main agents used in second-line immunotherapy for the treatment of autoimmune encephalitis. A literature review was performed in the main medical databases using the descriptors "treatment", "autoimmune encephalitis" and "pharmacological", using the Boolean operator "AND". All articles published between 2020-2025 were included in the primary analysis. It is observed that the response to first-line immunotherapies—such as corticosteroids, intravenous immunoglobulin, plasmapheresis and immunoadsorption—is currently unsatisfactory, leading approximately half or more of patients to require second-line therapies, such as rituximab and cyclophosphamide. Therefore, the treatment of autoimmune encephalitis must be individualized, considering the clinical picture and the risks of each therapy. Advances in research are essential to improve therapeutic strategies and ensure safer and more effective options.