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Inflammatory activity and vitamin D levels in an MS population treated with rituximab

Johan Linden1, Gabriel Granåsen2, Jonatan Salzer1

  • 1Department of Pharmacology and Clinical Neuroscience, Umeå University, Sweden.

Multiple Sclerosis Journal - Experimental, Translational and Clinical
|February 26, 2019
PubMed
Abstract

Insights

Rituximab treatment for multiple sclerosis showed very low inflammatory activity and few relapses. Higher vitamin D levels were linked to better self-perceived health and lower C-reactive protein in these patients.

Area of Science:

  • Neurology
  • Immunology
  • Endocrinology

Background:

  • Rituximab is a common disease-modifying treatment for multiple sclerosis (MS) at Umeå University Hospital.
  • There's a growing trend of vitamin D supplementation among MS patients on rituximab.
  • Follow-up studies are essential to evaluate the efficacy and safety of these off-label treatments.

Purpose of the Study:

  • To assess inflammatory markers and adverse events in MS patients receiving rituximab.
  • To investigate the relationship between 25-hydroxy-vitamin D levels and clinical outcomes in this cohort.
  • To explore associations between vitamin D status and treatment-related side effects.

Main Methods:

  • Retrospective analysis of clinical data from 272 MS patients treated with rituximab.
  • Evaluation of relapses, disability progression, and side effects.
  • Assessment of magnetic resonance imaging (MRI) findings, laboratory markers (including 25-hydroxy-vitamin D), and self-reported health status.

Main Results:

  • A low rate of relapses (seven) and minimal new inflammatory lesions on MRI (1.3% T2 lesions, 0.25% contrast-enhancing) were observed during a mean follow-up of 43 months.
  • Lower 25-hydroxy-vitamin D levels were associated with new T2 lesions on MRI (62 vs. 81 nmol/l).
  • Elevated 25-hydroxy-vitamin D levels correlated with improved self-perceived health and lower C-reactive protein, but not with increased side effects.

Conclusions:

  • Rituximab treatment in this MS population, with increasing vitamin D use, demonstrated exceptionally low inflammatory activity.
  • Higher 25-hydroxy-vitamin D levels were associated with favorable outcomes, including better self-perceived health and reduced inflammation.
  • These findings suggest a potential beneficial role for vitamin D in managing MS patients treated with rituximab.
Keywords:
MRIMultiple sclerosisdisease-modifying therapiesrituximabvitamin D

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