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

J Neurol. 2018 Jul;265(7):1690-1697. doi: 10.1007/s00415-018-8899-3. Epub 2018 May 21.

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.

Keywords: Anti-CD20 monoclonal antibody; Multiple sclerosis; Progressive multiple sclerosis; Relapsing-remitting multiple sclerosis; Rituximab; Treatment.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Disability Evaluation
  • Female
  • Follow-Up Studies
  • Hospitals / statistics & numerical data
  • Humans
  • Immunologic Factors / therapeutic use*
  • Male
  • Multiple Sclerosis, Relapsing-Remitting / drug therapy*
  • Oligoclonal Bands / metabolism
  • Retrospective Studies
  • Rituximab / therapeutic use*
  • Spain

Substances

  • Immunologic Factors
  • Oligoclonal Bands
  • Rituximab