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Journal of Neurology

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21.05.2018 | Original Communication

Efficacy and safety of rituximab in relapsing and progressive multiple sclerosis: a hospital-based study

verfasst von: Carmen Alcalá, F. Gascón, F. Pérez-Miralles, S. Gil-Perotín, A. Navarré, I. Boscá, F. Coret, B. Casanova

Erschienen in: Journal of Neurology | Ausgabe 7/2018

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Abstract

Introduction

Rituximab is considered as a potential therapeutic option in relapsing-remitting (RRMS) and progressive forms (PMS) of multiple sclerosis (MS).

Objective

To investigate the effectiveness and safety of rituximab in MS.

Patients and methods

Observational study of effectiveness (clinical and radiological) and safety of rituximab in RRMS and PMS.

Results

A total of 90 rituximab-treated patients were collected: 31 RRMS and 59 PMS All patients had an active disease despite standard treatment. The annualized relapse rate (ARR) the year before rituximab was 0.86, 53.3% of patients had gadolinium enhanced lesion, and mean Expanded Disability Status Scale (EDSS) had increased from 4.2 to 4.9. During treatment, the ARR was reduced an 88.4% (p < 0.001). A significant decrease of EDSS to 4.6 was observed (p = 0.01) after 1 year of treatment, which remained stable during the second year in both groups. There was no evidence of disease activity in 70% of total sample, 74.2% of RRMS, and 67% of the PMS patients. Infusion-related symptoms were the most prevalent side effect (18.8%) and most were mild. Three thrombotic events were detected.

Conclusion

Rituximab could be an effective and safe treatment in aggressive RRMS. Some selected PMS patients could also benefit from this treatment.

Duddy M, Bar-Or A (2006) B-cells in multiple sclerosis. Int MS J 13:84–90PubMed

Hauser SL (2015) The Charcot Lecture|beating MS: a story of B cells, with twists and turns. Mult Scler 21:8–21. https://doi.org/10.1177/1352458514561911 CrossRefPubMed

Lucchinetti C, Brück W, Parisi J et al (2000) Heterogeneity of multiple sclerosis lesions: implications for the pathogenesis of demyelination. Ann Neurol 47:707–717CrossRefPubMed

Serafini B, Rosicarelli B, Magliozzi R et al (2004) Detection of ectopic B-cell follicles with germinal centers in the meninges of patients with secondary progressive multiple sclerosis. Brain Pathol 14:164–174CrossRefPubMed

Christensen JR, Börnsen L, Ratzer R et al (2013) Systemic inflammation in progressive multiple sclerosis involves follicular T-helper, Th17- and activated B-cells and correlates with progression. PLoS One 8:e57820. https://doi.org/10.1371/journal.pone.0057820 CrossRefPubMedCentral

Boross P, Leusen JHW (2012) Mechanisms of action of CD20 antibodies. Am J Cancer Res 2:676–690PubMedPubMedCentral

He D, Guo R, Zhang F et al. (2013) Rituximab for relapsing-remitting multiple sclerosis. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD009130.pub3 CrossRefPubMed

Castillo-Trivino T, Braithwaite D, Bacchetti P, Waubant E (2013) Rituximab in relapsing and progressive forms of multiple sclerosis: a systematic review. PLoS One 8:e66308. https://doi.org/10.1371/journal.pone.0066308 CrossRefPubMedPubMedCentral

Bar-Or A, Calabresi PAJ, Arnold D et al (2008) Rituximab in relapsing-remitting multiple sclerosis: a 72-week, open-label, phase I trial. Ann Neurol 63:395–400. https://doi.org/10.1002/ana.21363 CrossRefPubMed

10.

Hauser SL, Waubant E, Arnold DL et al (2008) B-cell depletion with rituximab in relapsing-remitting multiple sclerosis. N Engl J Med 358:676–688. https://doi.org/10.1056/NEJMoa0706383 CrossRefPubMed

11.

Naismith RT, Piccio L, Lyons JA et al (2010) Rituximab add-on therapy for breakthrough relapsing multiple sclerosis: a 52-week phase II trial. Neurology 74:1860–1867. https://doi.org/10.1212/WNL.0b013e3181e24373 CrossRefPubMedPubMedCentral

12.

Hawker K, O’Connor P, Freedman MS et al (2009) Rituximab in patients with primary progressive multiple sclerosis: results of a randomized double-blind placebo-controlled multicenter trial. Ann Neurol 66:460–471. https://doi.org/10.1002/ana.21867 CrossRefPubMed

13.

Salzer J, Svenningsson R, Alping P et al (2016) Rituximab in multiple sclerosis. Neurology 87:2074–2081. https://doi.org/10.1212/WNL.0000000000003331 CrossRefPubMedPubMedCentral

14.

Alping P, Frisell T, Novakova L et al (2016) Rituximab versus fingolimod after natalizumab in multiple sclerosis patients. Ann Neurol 79:950–958. https://doi.org/10.1002/ana.24651 CrossRefPubMed

15.

Sola P, Mandrioli J, Simone AM et al (2011) Primary progressive versus relapsing-onset multiple sclerosis: presence and prognostic value of cerebrospinal fluid oligoclonal IgM. Mult Scler 17:303–311. https://doi.org/10.1177/1352458510386996 CrossRefPubMed

16.

Ferraro D, Simone AM, Bedin R et al (2013) Cerebrospinal fluid oligoclonal IgM bands predict early conversion to clinically definite multiple sclerosis in patients with Clinically Isolated Syndrome. J Neuroimmunol 257:76–81. https://doi.org/10.1016/j.jneuroim.2013.01.011 CrossRefPubMed

17.

Villar LM, Casanova B, Ouamara N et al (2014) Immunoglobulin M oligoclonal bands: biomarker of targetable inflammation in primary progressive multiple sclerosis. Ann Neurol 76:231–240. https://doi.org/10.1002/ana.24190 CrossRefPubMed

18.

Boscá I, Magraner MJ, Coret F et al (2010) The risk of relapse after a clinically isolated syndrome is related to the pattern of oligoclonal bands. J Neuroimmunol 226:143–146. https://doi.org/10.1016/j.jneuroim.2010.05.032 CrossRefPubMed

19.

Bosca I, Pascual AM, Casanova B et al (2008) Four new cases of therapy-related acute promyelocytic leukemia after mitoxantrone. Neurology 71:457–458. https://doi.org/10.1212/01.wnl.0000324422.69067.e7 CrossRefPubMed

20.

van Vollenhoven RF, Fleischmann RM, Furst DE et al (2015) Longterm safety of rituximab: final report of the rheumatoid arthritis global clinical trial program over 11 years. J Rheumatol 42:1761–1766. https://doi.org/10.3899/jrheum.150051 CrossRefPubMed

21.

Sikkema T, Schuiling WJ, Hoogendoorn M (2013) Progressive multifocal leukoencephalopathy during treatment with rituximab and CHOP chemotherapy in a patient with a diffuse large B-cell lymphoma. BMJ Case Rep. https://doi.org/10.1136/bcr-2012-008142 PubMedPubMedCentralCrossRef

22.

Clifford DB, Ances B, Costello C et al (2011) Rituximab-associated progressive multifocal leukoencephalopathy in rheumatoid arthritis. Arch Neurol 68:1156–1164. https://doi.org/10.1001/archneurol.2011.103 CrossRefPubMedPubMedCentral

23.

Dada R, Zekri J, Ramal B, Ahmad K Acute jugular vein thrombosis during rituximab administration: review of the literature. J Oncol Pharm Pract 22:165–169. https://doi.org/10.1177/1078155214543278

24.

Montalban X, Hauser SL, Kappos L et al (2017) Ocrelizumab versus placebo in primary progressive multiple sclerosis. N Engl J Med 376:209–220. https://doi.org/10.1056/NEJMoa1606468 CrossRefPubMed

25.

Martínez-Yélamos S, Martínez-Yélamos A, Martín Ozaeta G et al (2006) Regression to the mean in multiple sclerosis. Mult Scler 12:826–829. https://doi.org/10.1177/1352458506070820 CrossRefPubMed

Titel: Efficacy and safety of rituximab in relapsing and progressive multiple sclerosis: a hospital-based study
verfasst von: Carmen Alcalá
F. Gascón
F. Pérez-Miralles
S. Gil-Perotín
A. Navarré
I. Boscá
F. Coret
B. Casanova
Publikationsdatum: 21.05.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: Journal of Neurology / Ausgabe 7/2018
Print ISSN: 0340-5354
Elektronische ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-018-8899-3

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Efficacy and safety of rituximab in relapsing and progressive multiple sclerosis: a hospital-based study

Abstract

Introduction

Objective

Patients and methods

Results

Conclusion

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Springer Medizin

Abstract

Introduction

Objective

Patients and methods

Results

Conclusion

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