Safety and Efficacy of Rituximab in Multiple Sclerosis: A Retrospective Observational Study.
Objective: To evaluate the efficacy and safety of rituximab in multiple sclerosis in a clinical practice setting.Methods: Clinical data for all adult patients with multiple sclerosis (MS) treated with off-label rituximab at a single MS center in Lebanon between March 2008 and April 2017 were retrosp...
| Publicado en: | Journal of Immunology Research pp. 1 - 10 |
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| Autores principales: | , , , , , |
| Formato: | Journal Article |
| Publicado: |
Wiley-Blackwell
11/12/2018
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=132959986&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 132959986 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 23148861 GZMW jtl: Journal of Immunology Research issn: 23148861 maglogo: N pubinfo: dt: 11/12/2018 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 132959986 132959986 NLM30539030 10.1155/2018/9084759 NLM30539030 132959986 ppf: 1 ppct: 9 formats: tig: atl: Safety and Efficacy of Rituximab in Multiple Sclerosis: A Retrospective Observational Study. aug: au: Yamout, Bassem I. El-Ayoubi, Nabil K. Nicolas, Johny El Kouzi, Yehya Khoury, Samia J. Zeineddine, Maya M. affil: Nehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut Medical Center, Beirut, Lebanon sug: subj: Immunologic Factors Therapeutic Use Brain Pathology Multiple Sclerosis Diet Therapy Antigens, Surface Immunology Retrospective Design Prospective Studies Brain Lebanon Magnetic Resonance Imaging Immunologic Factors Adverse Effects Adult Prescriptions, Drug Disease Progression Female Middle Age Male Scales Adult: 19-44 years Middle Aged: 45-64 years Female Male ab: Objective: To evaluate the efficacy and safety of rituximab in multiple sclerosis in a clinical practice setting.Methods: Clinical data for all adult patients with multiple sclerosis (MS) treated with off-label rituximab at a single MS center in Lebanon between March 2008 and April 2017 were retrospectively collected from medical charts. The main efficacy outcomes assessed were annualized relapse rate (ARR) and proportion of patients free from relapses, disability progression, or magnetic resonance imaging (MRI) activity.Results: A total of 89 rituximab-treated patients were included: 59 relapsing-remitting MS (RRMS) and 30 progressive MS (PMS). Patients were treated with 1000 or 2000 mg rituximab IV every 6-12 months for a mean duration of 22.2 ± 24.8 months. The subjects were 65.2% females with a mean age of 40.5 ± 12.3 years and a mean disease duration of 7.9 ± 6.2 years. During treatment, the ARR decreased from 1.07 at baseline to 0.11 in RRMS (p < 0.0001) and from 0.25 to 0.16 in PMS patients (p = 0.593). The mean Expanded Disability Status Scale (EDSS) remained unchanged in both RRMS and PMS patients. Between baseline and the last follow-up, the percent of patients free from any new MRI lesions increased from 18.6% to 92.6% in the RRMS group and from 43.3% to 82% in the PMS group. No evidence of disease activity (NEDA) was achieved in 74% of patients at 1 year of treatment. A total of 64 adverse events (AEs) (71.9%) were recorded with the most common being infusion-related reactions in 25.8% of patients, all mild in nature. Two of our rituximab-treated patients experienced serious AEs requiring surgical interventions: pyoderma gangrenosum vaginalis with perianal abscess and fistula and an increase in the size of a meningioma. No case of progressive multifocal leukoencephalopathy (PML) was detected.Conclusion: In our real-world cohort, rituximab was well-tolerated and effective in reducing relapse rate and disability progression in relapsing-remitting and progressive MS patients. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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