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Efficacy and Safety of Rituximab in Central Nervous System Demyelinating Disorders

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 centr...

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Autores principales: Patil, Varsha A., Kamat, Saurabh N., Lalkaka, Jamshed A., Singhal, Bhim
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8680882/
https://www.ncbi.nlm.nih.gov/pubmed/35002132
http://dx.doi.org/10.4103/aian.AIAN_167_21
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author Patil, Varsha A.
Kamat, Saurabh N.
Lalkaka, Jamshed A.
Singhal, Bhim
author_facet Patil, Varsha A.
Kamat, Saurabh N.
Lalkaka, Jamshed A.
Singhal, Bhim
author_sort Patil, Varsha A.
collection PubMed
description 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.
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spelling pubmed-86808822022-01-06 Efficacy and Safety of Rituximab in Central Nervous System Demyelinating Disorders Patil, Varsha A. Kamat, Saurabh N. Lalkaka, Jamshed A. Singhal, Bhim Ann Indian Acad Neurol Original Article 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. Wolters Kluwer - Medknow 2021 2021-06-22 /pmc/articles/PMC8680882/ /pubmed/35002132 http://dx.doi.org/10.4103/aian.AIAN_167_21 Text en Copyright: © 2006 - 2021 Annals of Indian Academy of Neurology https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Patil, Varsha A.
Kamat, Saurabh N.
Lalkaka, Jamshed A.
Singhal, Bhim
Efficacy and Safety of Rituximab in Central Nervous System Demyelinating Disorders
title Efficacy and Safety of Rituximab in Central Nervous System Demyelinating Disorders
title_full Efficacy and Safety of Rituximab in Central Nervous System Demyelinating Disorders
title_fullStr Efficacy and Safety of Rituximab in Central Nervous System Demyelinating Disorders
title_full_unstemmed Efficacy and Safety of Rituximab in Central Nervous System Demyelinating Disorders
title_short Efficacy and Safety of Rituximab in Central Nervous System Demyelinating Disorders
title_sort efficacy and safety of rituximab in central nervous system demyelinating disorders
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8680882/
https://www.ncbi.nlm.nih.gov/pubmed/35002132
http://dx.doi.org/10.4103/aian.AIAN_167_21
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