B-lymphocyte-guided retreatment contributes to establish good effectiveness and safety profile in MS patients treated with rituximab.
Mult Scler Relat Disord
; 68: 104218, 2022 Dec.
Article
em En
| MEDLINE
| ID: mdl-36270253
ABSTRACT
BACKGROUND:
Rituximab is extensively used for multiple sclerosis (MS) treatment. However, the best dosage remains to be established. It has been proposed that retreatment could be guided by B lymphocyte (BL) percentages.OBJECTIVE:
To establish the best BL value for retreatment with rituximab in MS and to confirm the safety and efficacy of this approach.METHODS:
A prospective study was done with an exploratory cohort and a confirmatory cohort of MS patients treated with rituximab between 2017 and 2021. The first one comprised 10 MS patients with BL assessed every 3 months after rituximab infusion and retreatment done when BL values were ≥0.5%. The confirmatory cohort included 41 MS patients (41.5% women, 87.8% with secondary progressive MS, median age = 46.3 (interquartile range 41.3-52.1) years, disease duration = 14.1 (9-19.6) years, EDSS score = 5.5 (4.0-6.5)). The confirmatory cohort was treated with rituximab following the pattern established in the exploratory cohort.RESULTS:
In the exploratory cohort, ≥0.2% BL was established as the best value for retreatment because in most cases, a substantial increase of BL counts was preceded by initial values of 0.2-0.3%. In the confirmatory cohort, rituximab reduced the annualized relapse rate (ARR 0.56 vs. 0.125, p < 0.001), proportion of patients with appearance of new/enlarged T2 lesions (63.4% vs. 12.2%, p < 0.001), gadolinium-enhancing lesions (39% vs. 0%, p < 0.001), and confirmed disability progression (55% vs. 27.5%, p = 0.037). There were 22 patients (53.7%) who achieved NEDA-3. No patients had severe infections, and 10.7% cases had reduced IgG levels.CONCLUSION:
Rituximab treatment guided by BL showed high effectiveness and a good safety profile for MS patients after one year of treatment.Palavras-chave
Texto completo:
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Esclerose Múltipla Recidivante-Remitente
/
Esclerose Múltipla
Tipo de estudo:
Observational_studies
Limite:
Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Mult Scler Relat Disord
Ano de publicação:
2022
Tipo de documento:
Article