Retrospective Analysis of Rituximab Therapy for Myasthenia Gravis: A Case Series

Myasthenia gravis (MG) is a neuromuscular junction disorder that involves several dysfunctions that eventually lead to muscle fatigue and weakness. Although immunotherapeutics are considered an effective treatment option for MG, treatment-refractory cases are documented. In this case report, we evaluate the efficacy and safety of rituximab in treating three cases of myasthenia gravis admitted to the neurology department of a tertiary hospital. We conducted a retrospective analysis on three cases of MG treated with rituximab at the neurology department of King Abdullah Medical Hospital. Rituximab was used as a first-line treatment in three patients with new-onset, non-refractory generalized MG who tested positive for acetylcholine receptor antibodies and failed to respond adequately to conventional therapies. Changes in disease severity and quality of life were assessed using the 15-item Myasthenia Gravis Quality of Life (MG-QOL15) scale. We observed a significant improvement in disease symptoms and quality of life in all patients. Additionally, the oral prednisolone dose was reduced to less than 15 mg for all patients, with no reported side effects. This study suggests that patients with MG who test positive for acetylcholine receptor antibodies may benefit from rituximab as a safe and effective treatment alternative. In the three cases included in this analysis, rituximab led to notable improvements in quality of life, general clinical condition, and muscle weakness. Further studies with larger patient populations and longer follow-up periods are needed to validate these results and provide a more comprehensive understanding of rituximab's role in MG treatment.