Anti-CD20 therapy for multiple sclerosis-associated uveitis: A case series

Area of Science:

• Ophthalmology
• Neurology
• Immunology

Background:

• Multiple sclerosis (MS) affects approximately 1% of patients with uveitis.
• Data on the efficacy of immunotherapies for MS in treating MS-associated uveitis are limited.
• This study addresses the need for understanding treatment outcomes in this patient population.

Purpose of the Study:

• To investigate the ophthalmological outcomes of MS-associated uveitis patients treated with anti-CD20 therapy.
• To evaluate the impact of anti-CD20 therapy on uveitis activity and visual function.
• To assess the effect on MS disease activity and disability.

Main Methods:

• Retrospective study of 12 eyes from six patients with MS-associated uveitis refractory to prior immunotherapies.
• Assessment of uveitis activity using vitreous haze score, retinal vasculitis score, central retinal thickness (CRT), and visual acuity (VA).
• Evaluation of secondary outcomes including annualized relapse rates for uveitis and MS, cerebral MRI (cMRI) activity, and Expanded Disability Status Scale (EDSS) scores.

Main Results:

• Anti-CD20 therapy led to significant improvements in vitreous haze (p=0.002), retinal vasculitis (p=0.001), CRT (p=0.002), and VA (p=0.007).
• Median annualized uveitis relapse rate decreased from 0.59 to 0 (p<0.001), and MS relapse rate decreased from 0.62 to 0 (p<0.001).
• No cMRI disease activity was observed, and EDSS scores improved or remained stable; no severe adverse events were reported.

Conclusions:

• Anti-CD20 therapy demonstrates significant efficacy in improving ocular inflammation and visual acuity in MS-associated uveitis.
• The therapy effectively reduces both uveitis and MS disease activity, including relapses and cMRI findings.
• Anti-CD20 therapy represents a promising treatment option for patients with MS-associated uveitis.