Rituximab in neuromyelitis optica: A review of literature

Wong, Ericka; Vishwanath, Vijay; Kister, Ilya

doi:10.5316/wjn.v5.i1.39

Cited by 10 publications

(3 citation statements)

References 45 publications

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“…In other major immune-related diseases, most AEs of RTX were mild or moderate, 50–52 so that they could be solved by symptomatic treatments such as reducing the drug infusion rates, providing minor supportive treatments (e.g. steroid and antihistamine), 39 which was consistent with our findings in RTX for NMOSD. Nevertheless, it had been reported higher risks of progressive multifocal leukoencephalopathy (PML, 1/25000) 53 and hepatitis B (HBV) reactivation 54–56 of RTX for diseases such as rheumatoid arthritis.…”

Section: Discussionsupporting

confidence: 89%

“…However, the rates of patients with infusion-related AEs and any infections were numerically higher, 11,37 and the infections mainly occurred in pulmonary and urinary, but did not present as herpetic rashes or tuberculosis reactivation when compared with the previous studies. 37,38 Meanwhile, the rates of participants with RTX-related deaths before correction were numerically higher in this study, 11,37,39,40 especially when compared to the N-MOmentum study for inebilizumab 41 which reported two deaths with one clearly due to ongoing disease process rather than treatment. If we included the remaining death as a treatment effect the death rate was 0.5%.…”

Section: Discussionmentioning

confidence: 57%

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Adverse events of rituximab in neuromyelitis optica spectrum disorder: a systematic review and meta-analysis

Wang

Zhou

et al. 2021

Ther Adv Neurol Disord

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Background: The adverse events (AEs) of rituximab (RTX) for neuromyelitis optica spectrum disorder (NMOSD) are incompletely understood. Aim: To collate information on the reported the AEs of RTX in NMOSD and assess the quality of evidence. Methods: PubMed, EMBASE, Web of Science, Cochrane Library, Wanfang Data, CBM, CNKI, VIP, clinicaltrials.gov, and so on were searched for studies with control groups as well as for case series that had assessed the RTX-associated AEs. The incidence of AEs and the comparison of AE risks among different therapies were pooled. The GRADE was developed for evidence quality. Results: A total of 3566 records were identified. Finally, 36 studies (4 RCTs, 6 crochet studies, 2 NRCTs, and 24 case series), including 1542 patients (1299 females and 139 males), were included for final analyses. Rates of patients with any AEs, any serious AEs (SAEs), infusion-related AEs, any infection, respiratory infection, urinary infection, and death were 28.57%, 5.66%, 27.01%, 17.36%, 4.76%, 4.76%, and 0.17%, respectively. The results from subgroup analysis showed that AE rates were most likely not associated with covariates such as duration of illness and study designs. Very low-quality evidence suggested that the risk ratios (RR) of any AEs (0.84, 95% CI = 00.42–1.69, p = 0.62) and any infections (1.24 95% CI = 0.18–8.61) of RTX were similar to that of azathioprine, and the RR of any AEs of RXT was akin to that of mycophenolate mofetil (0.66, 95% CI = 0.32–1.35 p = 0.26). Evidence of low to high quality showed the lower RR of RTX in other AEs, but not in infusion-related AEs. Strategies to handle AEs focused on symptomatic treatments. Conclusions: RTX is mostly safer than other immunosuppressants in NMOSD: the incidence of RTX-associated AEs was not high, and when present, the AEs were usually mild or moderate and could be well controlled. Given its efficacy and safety, RTX could be recommended as a first-line treatment for NMOSD.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 57%

Adverse events of rituximab in neuromyelitis optica spectrum disorder: a systematic review and meta-analysis

Wang

Zhou

et al. 2021

Ther Adv Neurol Disord

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“…Se ha realizado estudios con dosis menores de Rituximab (100 mg cada semana durante 3 semanas) debido al coste económico, con resultados satisfactorios [19]. Sin embargo, la bibliografía reporta recaídas periódicas caracterizadas por episodios de mielitis con una desmielinización progresiva, por lo que se recomienda continuar con controles, medicación inmunosupresora, terapia física y apoyo psicológico [19,20].…”

Section: Discussionunclassified

Enfermedad de Devic con respuesta favorable a rituximab: reporte de un caso

Cobos

Córdova

Samaniego

et al. 2019

RFCM

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La enfermedad de Devic, también llamada neuromielitis óptica, es una entidad autoinmune desmielinizante del Sistema Nervioso Central, poco común que compromete los nervios ópticos y la médula espinal, ocasionando pérdida de la agudeza visual y afección motora. A continuación, se presenta el caso clínico de una mujer de 25 años, que presenta signos de mielopatía y amaurosis súbitas, cumpliendo criterios para neuromielitis óptica. Se inicia tratamiento con bolos de metilprednisolona sin mejoría, decidiéndose administrar Rituximab con respuesta favorable temprana. El Rituximab pertenece al grupo de anticuerpos monoclonales anti-CD20, una opción importante ante la falta de respuesta a la primera línea de tratamiento.

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Common and Rare Manifestations of Neuromyelitis Optica Spectrum Disorder

Rosales

Kister

2016

Curr Allergy Asthma Rep

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The discovery of a highly specific biomarker of neuromyelitis optica (NMO)-the anti-aquaporin-4 (AQP4) antibody-has opened new paths to understanding disease pathogenesis and afforded a way to confirm the diagnosis in clinical practice. An important consequence of the discovery is the broadening of the spectrum of syndromes seen in the context of AQP4 autoimmunity. These syndromes have been subsumed under the rubric of NMO spectrum disorder (NMOSD). The current classification recognizes not only optic neuritis and myelitis as core syndromes of NMOSD but also cerebral, diencephalic, brainstem, and area postrema syndromes. These neurologic syndromes are the focus of our review. AQP4 is also expressed in many organs outside of the central nervous system, and this may explain some of the unusual, non-neurologic features that have been occasionally reported in NMOSD. Our review catalogues non-neurologic manifestations seen in NMOSD and concludes with a discussion of frequently associated autoimmune and neoplastic comorbidities of NMOSD.

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Rituximab in neuromyelitis optica: A review of literature

Cited by 10 publications

References 45 publications

Adverse events of rituximab in neuromyelitis optica spectrum disorder: a systematic review and meta-analysis

Adverse events of rituximab in neuromyelitis optica spectrum disorder: a systematic review and meta-analysis

Enfermedad de Devic con respuesta favorable a rituximab: reporte de un caso

Common and Rare Manifestations of Neuromyelitis Optica Spectrum Disorder

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