Rituximab in refractory and non-refractory myasthenia: A retrospective multicenter study

Authors


  • Disclosures: C.T. serves on scientific advisory boards for and has received honoraria from Novartis, Biogen Idec, Merck Serono, and Lundbeck, and serves on the editorial board of Revue Neurologique. P.V. serves on a scientific advisory board for Merck Serono, Biogen Idec, Bayer Schering Pharma, Teva Pharmaceutical Industries, Ltd., and Sanofi-Aventis; has received funding for travel and/or speaker honoraria from Merck Serono, Biogen Idec, and Bayer Schering Pharma; and receives research support from Merck Serono and Biogen Idec. J.d.S. serves on scientific advisory boards for and has received honoraria from Biogen Idec, LFB, Merck Serono, Sanofi-Aventis, and Bayer Schering Pharma, and serves on the editorial board of Revue Neurologique. C.L. has received travel expenses and/or honoraria for lectures or educational activities not funded by industry; serves on the editorial board of Revue Neurologique; has received speaker honoraria from Biogen Idec, Bayer Schering Pharma, Merck Serono, Sanofi-Aventis, and Teva Pharmaceutical Industries, Ltd.; and serves as a consultant to the Institut National de Recherche en Informatique et en Automatique (INRIA).

Abstract

Introduction:

Few data are available about the effect of rituximab (RTX) on refractory (RM) and non-refractory (NRM) myasthenia.

Methods:

This retrospective multicenter study involved 13 RM and 7 NRM patients treated with sequential RTX infusions over 2 years, on average. RTX was used as a substitute for corticosteroids in NRM patients. Disability was assessed using the annualized relapse rate (ARR) and Myasthenia Gravis Foundation of America (MGFA) scores.

Results:

RTX induction decreased the ARR from 2.1 to 0.3 (P < 0.001), and lowered MGFA scores from 5–3b to 4b–0 in RM patients, and from 1.9 to 0.1 (P < 0.001) and 4b–2b to 3b–0 in NRM patients. No side effects were reported in either group, except for 1 case of spondylodiscitis 1 year after the last RTX infusion. Within a year after RTX induction, complete corticosteroid withdrawal was obtained in 7 RM and 4 NRM patients.

Conclusions:

RTX is efficacious and well-tolerated. Its use allows for dose reduction or withdrawal of corticosteroids. Muscle Nerve, 2012

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