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Published on: December 9, 2015
Efficacy and safety of rituximab in relapsing and progressive multiple sclerosis: a hospital-based study
Carmen Alcalá1, F Gascón2, F Pérez-Miralles3
1Unit of Neuroimmunology, Department of Neurology, Hospital Universitari i Politècnic La Fe, 106 Avenue Fernando Abril Martorell, 46026, Valencia, Spain. mc.alcalavicente@gmail.com.
Introduction:
Rituximab is considered as a potential therapeutic option in relapsing-remitting (RRMS) and progressive forms (PMS) of multiple sclerosis (MS).
Objective:
To investigate the effectiveness and safety of rituximab in MS.
Patients And Methods:
Observational study of effectiveness (clinical and radiological) and safety of rituximab in RRMS and PMS.
Results:
A total of 90 rituximab-treated patients were collected: 31 RRMS and 59 PMS All patients had an active disease despite standard treatment. The annualized relapse rate (ARR) the year before rituximab was 0.86, 53.3% of patients had gadolinium enhanced lesion, and mean Expanded Disability Status Scale (EDSS) had increased from 4.2 to 4.9. During treatment, the ARR was reduced an 88.4% (p < 0.001). A significant decrease of EDSS to 4.6 was observed (p = 0.01) after 1 year of treatment, which remained stable during the second year in both groups. There was no evidence of disease activity in 70% of total sample, 74.2% of RRMS, and 67% of the PMS patients. Infusion-related symptoms were the most prevalent side effect (18.8%) and most were mild. Three thrombotic events were detected.
Conclusion:
Rituximab could be an effective and safe treatment in aggressive RRMS. Some selected PMS patients could also benefit from this treatment.
Insights
Rituximab significantly reduced relapse rates and disease progression in multiple sclerosis (MS) patients. This B-cell depleting therapy demonstrated effectiveness and safety in both relapsing-remitting MS and selected progressive MS cases.
Area of Science:
- Neuroimmunology
- Clinical Neurology
- Pharmacology
Background:
- Rituximab is a potential therapeutic option for relapsing-remitting multiple sclerosis (RRMS) and progressive multiple sclerosis (PMS).
- Assessing rituximab's efficacy and safety in MS is crucial for treatment decisions.
Purpose of the Study:
- To evaluate the clinical and radiological effectiveness of rituximab in MS patients.
- To assess the safety profile of rituximab treatment in RRMS and PMS.
Main Methods:
- Observational study design.
- Included 90 patients with RRMS (31) and PMS (59) with active disease despite standard treatments.
- Collected data on annualized relapse rate (ARR), gadolinium-enhanced lesions, and Expanded Disability Status Scale (EDSS).
Main Results:
- Rituximab reduced ARR by 88.4% (p < 0.001) and EDSS significantly decreased to 4.6 (p = 0.01) after one year.
- 70% of patients showed no evidence of disease activity (74.2% RRMS, 67% PMS).
- Most common side effect was mild infusion-related symptoms (18.8%); three thrombotic events occurred.
Conclusions:
- Rituximab is an effective and safe treatment for aggressive RRMS.
- Selected PMS patients may also benefit from rituximab therapy.
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