Relapses and Serious Infections in Patients with Neuromyelitis Optica Spectrum Disorder Treated with Rituximab: A...

Area of Science:

• Neuroimmunology
• Central Nervous System Disorders
• Autoimmune Diseases

Background:

• Neuromyelitis optica spectrum disorder (NMOSD) is a rare, autoimmune, central nervous system disease.
• Rituximab is frequently used for relapse prevention in NMOSD.
• Understanding treatment risks is crucial for patient management.

Purpose of the Study:

• To evaluate relapse and severe infectious event (SIE) risks in NMOSD patients treated with rituximab.
• To compare these risks across different NMOSD serotypes (AQP4+, MOG+, double-negative).

Main Methods:

• Single-center retrospective cohort study.
• Inclusion of 42 NMOSD patients (24 AQP4+, 8 MOG+, 10 double-negative).
• Analysis of relapse rates and SIEs during rituximab treatment (mean 4.0 years).

Main Results:

• 50% of patients experienced relapses; MOG+ patients had a 3x higher relapse risk than AQP4+ patients.
• 40% of patients had SIEs; AQP4+ patients had a 5.3x higher SIE risk than MOG+ patients.
• Incomplete B-cell suppression and IgG levels did not correlate with relapse or SIE risk, respectively.

Conclusions:

• Rituximab treatment in NMOSD is associated with substantial risks of both relapses and severe infections.
• Close monitoring for disease activity and infections is essential during rituximab therapy for NMOSD.
• Risk stratification by serotype is important for managing NMOSD patients on rituximab.