Rituximab efficacy at different initial and maintenance doses in neuromyelitis optica spectrum disorder : Experience from a national health institute in México
Copyright © 2020. Published by Elsevier B.V..
BACKGROUND: NMOSD is an inflammatory disorder of the central nervous system that primarily affects the optic nerves and spinal cord. Rituximab (RTX) is a monoclonal antibody directed against CD20, an epitope expressed on pre-B and mature B cells. It has of wide use in several antibody-mediated autoimmune diseases.
OBJECTIVES: To demonstrate RTX clinical efficacy at different initial and maintenance doses administered in patients with NMOSD.
METHODS: In this retrospective/observational study we recruited subjects with NMOSD with at least one RTX infusion. Annual relapse rates (ARR) were compared in several induction and maintenance regimens with RTX in 66 patients with NMOSD.
RESULTS: Fifty-four (81.8%) were female and two thirds (66.7%) had positive anti-AQP4 antibodies. The most prevalent induction and maintenance regimens were 1000 mg on days 1 and 15 (51.5%) and 1000 mg every 6 months (40.9%), respectively. Overall, the annual relapse rate (ARR) decreased from 1.15 to 0.46 with RTX (p < 0.001). In patients with persistent relapses, the ARR decreased from 1.66 to 1.22, representing a relative risk reduction of 24%. Treatment with RTX decreased the ARR from 1.36 to 0.4 in the 500 mg induction and maintenance dose subgroup, and from 0.7 to 0.4 in the 1000 mg induction and maintenance dose subgroup.
CONCLUSION: RTX treatment in patients with NMOSD demonstrated a marked and sustained reduction in the ARR, regardless of induction and maintenance regimens. EDSS stability was observed, even in patients with active and severe NMOSD.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:419 |
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| Enthalten in: |
Journal of the neurological sciences - 419(2020) vom: 15. Dez., Seite 117204 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Casallas-Vanegas, Adriana [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 14.05.2021 Date Revised 14.05.2021 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.jns.2020.117204 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM317290835 |
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| 100 | 1 | |a Casallas-Vanegas, Adriana |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Rituximab efficacy at different initial and maintenance doses in neuromyelitis optica spectrum disorder |b Experience from a national health institute in México |
| 264 | 1 | |c 2020 | |
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| 500 | |a Date Completed 14.05.2021 | ||
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| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2020. Published by Elsevier B.V. | ||
| 520 | |a BACKGROUND: NMOSD is an inflammatory disorder of the central nervous system that primarily affects the optic nerves and spinal cord. Rituximab (RTX) is a monoclonal antibody directed against CD20, an epitope expressed on pre-B and mature B cells. It has of wide use in several antibody-mediated autoimmune diseases | ||
| 520 | |a OBJECTIVES: To demonstrate RTX clinical efficacy at different initial and maintenance doses administered in patients with NMOSD | ||
| 520 | |a METHODS: In this retrospective/observational study we recruited subjects with NMOSD with at least one RTX infusion. Annual relapse rates (ARR) were compared in several induction and maintenance regimens with RTX in 66 patients with NMOSD | ||
| 520 | |a RESULTS: Fifty-four (81.8%) were female and two thirds (66.7%) had positive anti-AQP4 antibodies. The most prevalent induction and maintenance regimens were 1000 mg on days 1 and 15 (51.5%) and 1000 mg every 6 months (40.9%), respectively. Overall, the annual relapse rate (ARR) decreased from 1.15 to 0.46 with RTX (p < 0.001). In patients with persistent relapses, the ARR decreased from 1.66 to 1.22, representing a relative risk reduction of 24%. Treatment with RTX decreased the ARR from 1.36 to 0.4 in the 500 mg induction and maintenance dose subgroup, and from 0.7 to 0.4 in the 1000 mg induction and maintenance dose subgroup | ||
| 520 | |a CONCLUSION: RTX treatment in patients with NMOSD demonstrated a marked and sustained reduction in the ARR, regardless of induction and maintenance regimens. EDSS stability was observed, even in patients with active and severe NMOSD | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Antigen-antibody complex | |
| 650 | 4 | |a Central nervous system diseases | |
| 650 | 4 | |a Demyelinating autoimmune diseases | |
| 650 | 4 | |a Immunosuppression | |
| 650 | 4 | |a Neuromyelitis optica spectrum disorders | |
| 650 | 4 | |a Rituximab | |
| 650 | 7 | |a Immunologic Factors |2 NLM | |
| 650 | 7 | |a Rituximab |2 NLM | |
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| 700 | 1 | |a Gomez-Figueroa, Enrique |e verfasserin |4 aut | |
| 700 | 1 | |a de Saráchaga, Adib Jorge |e verfasserin |4 aut | |
| 700 | 1 | |a Zabala-Angeles, Indhira |e verfasserin |4 aut | |
| 700 | 1 | |a García-Estrada, Christian |e verfasserin |4 aut | |
| 700 | 1 | |a Salado-Burbano, Jorge C |e verfasserin |4 aut | |
| 700 | 1 | |a DiazGranados-Palacio, María Clara |e verfasserin |4 aut | |
| 700 | 1 | |a Corona-Vázquez, Teresita |e verfasserin |4 aut | |
| 700 | 1 | |a de Jesús Flores-Rivera, José |e verfasserin |4 aut | |
| 700 | 1 | |a Rivas-Alonso, Verónica |e verfasserin |4 aut | |
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