Thomas Mathew1, Saji K John2, Vikram Kamath3, Uday Murgod4, Kurian Thomas2, Anita Angela Baptist2, Manjusha Therambil2, Asha Shaji2, Raghunandan Nadig2, Sagar Badachi2, Delon D Souza2, Sonia Shivde5, Amrutha Avati5, G R K Sarma2, G G Sharath Kumar2, Saikanth Deepalam2, Gareth J Parry2. 1. Department of Neurology, St. John's Medical College Hospital, Sarjapura Road, Bengaluru, Karnataka,560034, India. Electronic address: chakkuthom@hotmail.com. 2. Department of Neurology, St. John's Medical College Hospital, Sarjapura Road, Bengaluru, Karnataka,560034, India. 3. Department of Neurology, Apollo Hospital, Bengaluru, Karnataka, India. 4. Department of Neurology, Manipal Hospital, Old Airport Road, Bangalore, India. 5. Department of Neurology, St. John's Medical College Hospital, Sarjapura Road, Bengaluru, Karnataka,560034, India; Department of Neurology, Apollo Hospital, Bengaluru, Karnataka, India; Department of Neurology, Manipal Hospital, Old Airport Road, Bangalore, India.
Abstract
BACKGROUND: Rituximab is increasingly being used in treatment of multiple Sclerosis (MS) in our centers due to its easy availability, efficacy and favorable side effect profile. Here we describe experience with rituximab over a period of 4 years from three MS centers from south India. METHODS: The data of MS patients who were treated with rituximab in three MS centers at Bangalore, India, from December 2015 to December 2019 were collected and evaluated with respect to relapse rate, EDSS score and adverse events. RESULTS: Over the four-year study period 118 MS patients were evaluated, 80 of whom were on rituximab. 58 (72%) had RRMS, 15 (19%) SPMS and 7 (9%) PPMS. Most patients (89%) received rituximab at a dose of 500 mg every 6-12 months. Nine patients (11%), all with progressive MS were on 1 gm to 2 gm every 6 months. Follow up ranged from 1 year to 3 years, with a median of 2 years. 56 (97%) RRMS patients had no relapses during follow up. EDSS score improved by a score of 0.5-2.0 in 68 (85%) patients, remained same in 10 (12.5%) and worsened in 2 patients (2.5%). Most patients (91%) tolerated rituximab infusions well. There were no opportunistic infections or neoplasms. CONCLUSION: Anti B cell therapy with rituximab appears effective, safe and affordable in the treatment of MS in developing countries like India with resource limited settings.
BACKGROUND:Rituximab is increasingly being used in treatment of multiple Sclerosis (MS) in our centers due to its easy availability, efficacy and favorable side effect profile. Here we describe experience with rituximab over a period of 4 years from three MS centers from south India. METHODS: The data of MS patients who were treated with rituximab in three MS centers at Bangalore, India, from December 2015 to December 2019 were collected and evaluated with respect to relapse rate, EDSS score and adverse events. RESULTS: Over the four-year study period 118 MS patients were evaluated, 80 of whom were on rituximab. 58 (72%) had RRMS, 15 (19%) SPMS and 7 (9%) PPMS. Most patients (89%) received rituximab at a dose of 500 mg every 6-12 months. Nine patients (11%), all with progressive MS were on 1 gm to 2 gm every 6 months. Follow up ranged from 1 year to 3 years, with a median of 2 years. 56 (97%) RRMS patients had no relapses during follow up. EDSS score improved by a score of 0.5-2.0 in 68 (85%) patients, remained same in 10 (12.5%) and worsened in 2 patients (2.5%). Most patients (91%) tolerated rituximab infusions well. There were no opportunistic infections or neoplasms. CONCLUSION: Anti B cell therapy with rituximab appears effective, safe and affordable in the treatment of MS in developing countries like India with resource limited settings.