Efficacy and safety of rituximab in multiple sclerosis: Experience from a developing country

Mathew, Thomas; John, Saji K; Kamath, Vikram; Murgod, Uday; Thomas, Kurian; Baptist, Anita Angela; Therambil, Manjusha; Shaji, Asha; Nadig, Raghunandan; Badachi, Sagar; Souza, Delon D; Shivde, Sonia; Avati, Amrutha; Sarma, G.R.K.; Kumar, Gaurav; Deepalam, Saikanth; Parry, Gareth

doi:10.1016/j.msard.2020.102210

Cited by 22 publications

(26 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Based on our experience with rituximab in multiple sclerosis, where we use low dose regimens. 25,26 b. Pure B cell mediated disorders may respond well to smaller doses of rituximab.…”

Section: Discussionmentioning

confidence: 99%

Effective Early Treatment of AChR Antibody-Positive Myasthenia Gravis with Rituximab; the Experience from a Neuroimmunology Clinic in a Developing Country

Mathew

Thomas

John

et al. 2021

J Cent Nerv Syst Dis

Self Cite

View full text Add to dashboard Cite

Background: Rituximab is reserved for treating refractory myasthenia gravis (MG) patients. Here we report our experience with rituximab in AChR antibody positive generalized MG (gMG) and impending myasthenic crisis (IMC). Methods: This retrospective, observational study, conducted at a tertiary care, neuroimmunology clinic, analyzed the data of patients with AChR antibody positive gMG, treated with rituximab between 1st January 2016 and 30th October 2018. Results: Eleven patients with AChR antibody positive gMG received rituximab. Mean age of the cohort was 50.54 ± 18.71 years with 9 males. Seven out of 11 patients received rituximab in the early stage (<2 years from onset) and had good response to treatment. Four of the 5 patients with IMC improved with rituximab alone. In the 10 patients who regularly followed up, there was a significant difference between the QMG scores at baseline and at 1, 2, 6, 12, and 18 months ( P < .0001). Conclusion: Rituximab appears to be a potentially effective early treatment option for AChR antibody positive generalized MG and impending myasthenic crisis.

show abstract

“…Based on our experience with rituximab in multiple sclerosis, where we use low dose regimens. 25,26 b. Pure B cell mediated disorders may respond well to smaller doses of rituximab.…”

Section: Discussionmentioning

confidence: 99%

Effective Early Treatment of AChR Antibody-Positive Myasthenia Gravis with Rituximab; the Experience from a Neuroimmunology Clinic in a Developing Country

Mathew

Thomas

John

et al. 2021

J Cent Nerv Syst Dis

Self Cite

View full text Add to dashboard Cite

show abstract

“…The authors reported lower relapse rates in RRMS patients on rituximab therapy than in those who were on first- or second-line DMT. [ 8 ] In the Indian context, Mathew et al [ 24 ] reported their rituximab experience in 80 MS patients across 3 centres in South India. In their group of 58 RRMS patients, they found a significant improvement in ARR (p < 0.05), with 97% of them having no relapses during a 1 year follow-up period after rituximab therapy.…”

Section: Discussionmentioning

confidence: 99%

“…[ 8 ] The Swedish study found that the proportion of patients with CELs dropped from 26.2% to 4.6% on rituximab therapy, with new CELs occurring only during the initial 6 months after the start of therapy. [ 8 ] In the South Indian cohort (Mathew et al ),[ 24 ] CELs were seen in 20% of RRMS patients and in 10% of PPMS patients at baseline. After 1 year of treatment, no new enhancing lesions were observed in both groups.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of rituximab in central nervous system demyelinating disorders

Patil¹,

Kamat²,

Lalkaka³

et al. 2021

Ann Indian Acad Neurol

View full text Add to dashboard Cite

Background: Rituximab, an anti-CD20 monoclonal antibody, has been used worldwide as an off-label therapy in patients with multiple sclerosis (MS) and neuromyelitis optica spectrum disorders (NMOSD). Objective: The aim of the present study was to evaluate the efficacy and safety of rituximab in central nervous system demyelinating disorders in the Indian context. Methods: We conducted a retrospective analysis of patients with MS, NMOSD, and myelin oligodendrocyte glycoprotein antibody disease (MOGAD) who were treated with rituximab at a single tertiary care centre in Mumbai. Results: The study enrolled 102 patients (61 MS, 37 NMOSD and 4 MOGAD) from June 2008 to January 2020. Following rituximab therapy, 96.7% of MS, 67% of NMOSD, and 50% of MOGAD patients were free of relapses. The mean annualized relapse rate reduced from 2.17 to 0 for patients with relapsing remitting MS (RRMS), from 0.8 to 0 for secondary progressive MS (SPMS), from 2.5 to 0.14 for NMOSD, and from 3.43 to 1.04 for MOGAD. The median expanded disability status scale improved significantly in RRMS patients, worsened non-significantly in the SPMS group, and remained unchanged in NMOSD and MOGAD patients. On follow-up magnetic resonance imaging, there was a significant reduction in the number of MS patients developing new contrast enhancing lesions or new T2 lesions. Adverse events (infusion reactions or severe infections) occurred in 12 patients. Conclusion: Rituximab is effective and safe in Indian patients with MS and NMOSD.

show abstract

“…12 The main concerns regarding these practices are the effectiveness and safety of these medications. Published studies on MS treatment, using off-label therapies that are available regionally, 13,14 may be useful to help guide these decisions and alleviate concerns about efficacy and safety. Hospital databases might be queried for additional information.…”

Section: Editorialmentioning

confidence: 99%

Fair and equitable treatment for multiple sclerosis in resource-poor regions: The need for off-label therapies and regional treatment guidelines

Pandit

2021

Mult Scler

View full text Add to dashboard Cite

Efficacy and safety of rituximab in multiple sclerosis: Experience from a developing country

Cited by 22 publications

References 15 publications

Effective Early Treatment of AChR Antibody-Positive Myasthenia Gravis with Rituximab; the Experience from a Neuroimmunology Clinic in a Developing Country

Effective Early Treatment of AChR Antibody-Positive Myasthenia Gravis with Rituximab; the Experience from a Neuroimmunology Clinic in a Developing Country

Efficacy and safety of rituximab in central nervous system demyelinating disorders

Fair and equitable treatment for multiple sclerosis in resource-poor regions: The need for off-label therapies and regional treatment guidelines

Contact Info

Product

Resources

About