CD20 monoclonal antibodies for the treatment of multiple sclerosis: up-to-date

Ancau, Mihai; Berthele, Achim; Hemmer, Bernhard

doi:10.1080/14712598.2019.1611778

Cited by 40 publications

(42 citation statements)

References 88 publications

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“… 1 A growing body of evidence supports the notion of a strong suppressive effect on inflammatory disease activity in MS with B cell depleting therapies. 2 – 4 Unlike other MS DMTs, anti-CD20 biologics have been shown to be effective both in relapsing-remitting (RRMS) and primary progressive (PPMS). 1 , 5 , 6 Rituximab (RTX, Roche) is a mouse chimeric monoclonal antibody approved for the treatment of RA, lymphoma and systemic vasculitis.…”

Section: Introductionmentioning

confidence: 99%

A comparative study of tolerability and effects on immunoglobulin levels and CD19 cell counts with ocrelizumab vs low dose of rituximab in multiple sclerosis

Evertsson

Hoyt

Christensen

et al. 2020

Multiple Sclerosis Journal - Experimental, Translational and Cl

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Background Rituximab (RTX) and ocrelizumab (OCR) are two anti-CD20 biologics used in MS; however, comparisons on safety and efficacy are rare. Objective To compare treatment outcomes over the first year with RTX and OCR. Methods Retrospective cohort study comprising MS patients initiating RTX at the Karolinska University Hospital (Sweden; n = 311) and OCR at Rocky Mountain MS Clinic (Utah, USA; n = 161), respectively. Results Levels of immunoglobulin G measured in blood dropped 0.16 g/L (95% confidence interval 0.01 to 0.31) with each OCR infusion, but remained stable with RTX. In contrast, levels of immunoglobulin M decreased to a similar extent with both drugs. Ten and 15% of patients discontinued treatment with RTX and OCR, respectively (n.s), however, adverse events leading to treatment discontinuation were more common with OCR (6.8% vs 2.6%; p = 0.026). Only 3.1 and 1.6% discontinued OCR and RTX, respectively, due to lack of effect (n.s). The degree of B cell depletion was superior with OCR. Conclusion Overall, differences between the two treatments were small. Although the study design precludes robust conclusions regarding the risk-benefit with the studied therapies, our findings indicate that the tolerability and safety with RTX is not inferior to OCR.

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Section: Introductionmentioning

confidence: 99%

A comparative study of tolerability and effects on immunoglobulin levels and CD19 cell counts with ocrelizumab vs low dose of rituximab in multiple sclerosis

Evertsson

Hoyt

Christensen

et al. 2020

Multiple Sclerosis Journal - Experimental, Translational and Cl

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“…Moreover, two retrospective studies showed the effectiveness of RTX for progressive forms of MS as an off‐label therapy 13,14 . On the other hand, ocrelizumab (OCR), a humanized monoclonal anti‐CD20 antibody, was recently introduced as the first approved medication for PPMS after showing promising effects among patients aged 18‐55 years in a phase 3 trial 21,22 . The mentioned evidence could suggest possible efficacy of anti‐CD20 medications in SPMS as well.…”

Section: Introductionmentioning

confidence: 99%

Rituximab and glatiramer acetate in secondary progressive multiple sclerosis: A randomized clinical trial

et al. 2020

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Multiple sclerosis (MS) is an immune-mediated neurodegenerative disease characterized by demyelination of neurons in the central nervous system. 1,2 It is the most common cause of acquired disabling neurological disorder in young population worldwide and there is an ongoing increase in its prevalence and incidence in Europe, Mediterranean, and Middle East. 3,4 Relapsing remitting MS (RRMS) accounts for nearly 85% of MS cases and might evolve into the progressive form over time. 2,5 Around 25% of RRMS patients progress to secondary progressive MS (SPMS) by 10 years, and this rate grows as the duration of disease increases. 3,6 The progressive course is characterized by cumulative deterioration of neurological impairments, with or without relapses, with infrequent unstable minor improvements or plateau phases. 2

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“…Newer anti-CD20 monoclonal antibodies, such as ocrelizumab, feature an enhanced antibody-dependent cellular toxicity when compared to rituximab, with a proven efficacy in adult MS patients [11]. In conclusion, B-cell-depleting therapies consist of a promising therapeutic approach for pediatric MS, especially at the early stages of the disease, when B-cell-related phenomena are pronounced.…”

Section: Discussionmentioning

confidence: 99%

Rituximab as Rescue Therapy for Aggressive Pediatric Multiple Sclerosis

Vartzelis

Maritsi

Nikolaidou

et al. 2019

Case Reports in Pediatrics

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Multiple sclerosis is a chronic, debilitating disease. Almost one in ten patients with MS has a history of disease onset during childhood. Although numerous therapeutic options exist for adult MS, the available treatments for pediatric patients are still limited. One of the emerging therapies is rituximab, a monoclonal anti-CD20 chimeric antibody that can deplete the CD20+ lymphocyte populations. A 12-year-old boy presented with ataxia, paresthesias, and headache while his brain MRI showed numerous T2 contrast-enhancing lesions. Gamma globulin, steroids, and cyclophosphamide failed to intercept his disease, and he progressed to a rapid clinical and radiological deterioration. Treatment with rituximab reversed the disease course in a dramatic fashion, leading to complete remission.

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CD20 monoclonal antibodies for the treatment of multiple sclerosis: up-to-date

Cited by 40 publications

References 88 publications

A comparative study of tolerability and effects on immunoglobulin levels and CD19 cell counts with ocrelizumab vs low dose of rituximab in multiple sclerosis

A comparative study of tolerability and effects on immunoglobulin levels and CD19 cell counts with ocrelizumab vs low dose of rituximab in multiple sclerosis

Rituximab and glatiramer acetate in secondary progressive multiple sclerosis: A randomized clinical trial

Rituximab as Rescue Therapy for Aggressive Pediatric Multiple Sclerosis

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