Grayson Beecher1, Dustin Anderson1, Zaeem A Siddiqi1. 1. Department of Medicine, Division of Neurology, University of Alberta, 7-132 Clinical Sciences Building, 11350-83 Avenue, Edmonton, Alberta, T6G 2G3, Canada.
Abstract
INTRODUCTION: Rituximab appears to be beneficial in treatment-refractory myasthenia gravis (MG); however, prospective, long-term durability data are lacking. METHODS: In this prospective, open-label study of rituximab in refractory MG, 22 patients (10 nicotinic acetylcholine receptor, 9 muscle-specific tyrosine kinase, 3 seronegative) received rituximab at baseline, with repeat cycles driven by clinical worsening. Manual muscle testing (MMT) scores and CD19/CD20+ B-cell counts were serially monitored. RESULTS: At mean follow-up of 28.8 ± 19.0 months (range, 6-66), mean MMT scores declined from 10.6 ± 5.4 to 3.3 ± 3.1 (P < 0.0001). Mean prednisone dosage declined from 25.2 ± 15.1 to 7.3 ± 7.1 mg/d (P = 0.002). Ten relapses occurred, with average time to first relapse of 17.1 ± 5.5 months (range, 9-23). CD19/CD20+ count recovery did not predict relapse. Three patients experienced prolonged B-cell depletion (range, 24-45 months) after 1 cycle. DISCUSSION: Sustained clinical improvement was associated with rituximab after 1 cycle, with prolonged time to relapse and reduction in steroid dosage. Muscle Nerve 58: 453-456, 2018.
INTRODUCTION:Rituximab appears to be beneficial in treatment-refractory myasthenia gravis (MG); however, prospective, long-term durability data are lacking. METHODS: In this prospective, open-label study of rituximab in refractory MG, 22 patients (10 nicotinic acetylcholine receptor, 9 muscle-specific tyrosine kinase, 3 seronegative) received rituximab at baseline, with repeat cycles driven by clinical worsening. Manual muscle testing (MMT) scores and CD19/CD20+ B-cell counts were serially monitored. RESULTS: At mean follow-up of 28.8 ± 19.0 months (range, 6-66), mean MMT scores declined from 10.6 ± 5.4 to 3.3 ± 3.1 (P < 0.0001). Mean prednisone dosage declined from 25.2 ± 15.1 to 7.3 ± 7.1 mg/d (P = 0.002). Ten relapses occurred, with average time to first relapse of 17.1 ± 5.5 months (range, 9-23). CD19/CD20+ count recovery did not predict relapse. Three patients experienced prolonged B-cell depletion (range, 24-45 months) after 1 cycle. DISCUSSION: Sustained clinical improvement was associated with rituximab after 1 cycle, with prolonged time to relapse and reduction in steroid dosage. Muscle Nerve 58: 453-456, 2018.
Authors: Juan Carlos López-Hernández; Javier A Galnares-Olalde; Enrique Gómez-Figueroa; Adib Jorge de Sarachaga; Edwin Steven Vargas-Cañas Journal: Cureus Date: 2021-02-08
Authors: Raffi Topakian; Fritz Zimprich; Stephan Iglseder; Norbert Embacher; Michael Guger; Karl Stieglbauer; Dieter Langenscheidt; Jakob Rath; Stefan Quasthoff; Philipp Simschitz; Julia Wanschitz; David Windisch; Petra Müller; Dierk Oel; Günther Schustereder; Stefan Einsiedler; Christian Eggers; Wolfgang Löscher Journal: J Neurol Date: 2019-01-16 Impact factor: 4.849