Rescue Therapy Using Rituximab for Multiple Sclerosis

Clin Neuropharmacol. 2016 Jul-Aug;39(4):178-81. doi: 10.1097/WNF.0000000000000156.

Abstract

Objectives: The aim of the study was to describe the effectiveness and safety data of rituximab in a group of patients with relapsing-remitting multiple sclerosis (MS) treated with rituximab due to failure of previous treatments or concomitant autoimmune diseases.

Methods: This is an observational study. Rituximab was considered in case of failure of the second-line therapy, failure of the first-line therapy and a contraindication to second-line therapies, or concomitant autoimmune disease. Relapses, the Expanded Disability Status Scale, the EQ VAS, and magnetic resonance imaging activity were assessed.

Results: This study included 12 patients with relapsing-remitting MS. The mean (range) age of the patients was 35 (19-54) years. Ten patients were treated with rituximab because of treatment failure, and 2 patients were treated with rituximab because of the development of idiopathic thrombocytopenic purpura. The mean (range) follow-up duration after beginning rituximab was 40 (18-72) months. Rituximab was well tolerated, because no patient experienced serious adverse reactions or discontinued treatment. During treatment with rituximab, no patient suffered a clinical relapse, and magnetic resonance imaging activity was not detected. The Expanded Disability Status Scale scores improved in 11 of 12 patients and remained stable in 1 patient. The EuroQol visual analogue scale scores improved in 8 of 9 patients in whom the EuroQol visual analogue scale was assessed.

Conclusions: Treatment with rituximab seems to be safe and effective for some patients with relapsing-remitting MS who have failed to respond to first- and second-line therapies and may also be a useful option for patients with concomitant autoimmune disorders.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Disability Evaluation
  • Dose-Response Relationship, Drug
  • Female
  • Follow-Up Studies
  • Humans
  • Immunologic Factors / therapeutic use*
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Multiple Sclerosis / diagnostic imaging
  • Multiple Sclerosis / drug therapy*
  • Rituximab / therapeutic use*
  • Treatment Outcome*
  • Visual Analog Scale
  • Young Adult

Substances

  • Immunologic Factors
  • Rituximab