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Evaluating Rituximab Failure Rates in Neuromyelitis Optica Spectrum Disorder: A Nationwide Real-World Study From
Su-Hyun Kim1, Ju-Hong Min2, Sung-Min Kim3
1Department of Neurology, Research Institute and Hospital of National Cancer Center, Goyang, Korea.
Journal of Clinical Neurology (Seoul, Korea)
|March 11, 2025
Summary
Rituximab is effective for neuromyelitis optica spectrum disorder (NMOSD) with an 87% continuation rate. However, 19% of patients relapsed, indicating a need for alternative treatments.
Area of Science:
- Neurology
- Immunology
- Pharmacology
Background:
- Neuromyelitis optica spectrum disorder (NMOSD) treatments like eculizumab are effective but costly.
- Rituximab offers a cost-effective, off-label alternative for NMOSD relapse prevention.
- Quantifying real-world rituximab failure is crucial for guiding newer NMOSD therapies.
Purpose of the Study:
- To determine real-world rituximab failure rates in aquaporin-4-antibody-positive NMOSD patients.
- To anticipate the demand for newer approved NMOSD treatments (ANTs).
- To aid in resource allocation for NMOSD management.
Main Methods:
- Nationwide retrospective study of 605 aquaporin-4-antibody-positive NMOSD patients.
- Data collected from 22 centers in South Korea.
- Median follow-up of 47 months assessing rituximab efficacy and safety.
Main Results:
- 87% of patients (525/605) continued rituximab therapy.
- 19% of patients (117/605) experienced at least one relapse.
- 11% (68/605) had multiple or severe relapses; 2% discontinued rituximab due to adverse events.
Conclusions:
- Rituximab demonstrates significant efficacy in NMOSD treatment, with high patient continuation rates.
- A notable percentage of patients experienced relapses, underscoring the need for alternative therapies.
- Adverse events led to discontinuation in 2% of patients, further supporting the search for alternative NMOSD treatments.
