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Published on: May 4, 2017
Rituximab in refractory and non-refractory myasthenia: a retrospective multicenter study
Nicolas Collongues1, Olivier Casez, Arnaud Lacour
1Department of Neurology, University of Strasbourg, University Hospital of Hautepierre, 1 Avenue Molière, 67000 Strasbourg, France. nicolas.collongues@chru.strasbourg.fr
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.
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