Rituximab in refractory myasthenia gravis: Extended prospective study results.
Muscle Nerve
; 58(3): 452-455, 2018 09.
Article
em En
| MEDLINE
| ID: mdl-29742795
ABSTRACT
INTRODUCTION:
Rituximab appears to be beneficial in treatment-refractory myasthenia gravis (MG); however, prospective, long-term durability data are lacking.METHODS:
In this prospective, open-label study of rituximab in refractory MG, 22 patients (10 nicotinic acetylcholine receptor, 9 muscle-specific tyrosine kinase, 3 seronegative) received rituximab at baseline, with repeat cycles driven by clinical worsening. Manual muscle testing (MMT) scores and CD19/CD20+ B-cell counts were serially monitored.RESULTS:
At mean follow-up of 28.8 ± 19.0 months (range, 6-66), mean MMT scores declined from 10.6 ± 5.4 to 3.3 ± 3.1 (P < 0.0001). Mean prednisone dosage declined from 25.2 ± 15.1 to 7.3 ± 7.1 mg/d (P = 0.002). Ten relapses occurred, with average time to first relapse of 17.1 ± 5.5 months (range, 9-23). CD19/CD20+ count recovery did not predict relapse. Three patients experienced prolonged B-cell depletion (range, 24-45 months) after 1 cycle.DISCUSSION:
Sustained clinical improvement was associated with rituximab after 1 cycle, with prolonged time to relapse and reduction in steroid dosage. Muscle Nerve 58 453-456, 2018.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Rituximab
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Fatores Imunológicos
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Miastenia Gravis
Tipo de estudo:
Guideline
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article