Artikel ; Online: Efficacy of Rituximab Outlasts B-Cell Repopulation in Multiple Sclerosis: Time to Rethink Dosing?
Neurology(R) neuroimmunology & neuroinflammation
2023 Band 10, Heft 5
Abstract: Background and objectives: Patients with multiple sclerosis (PwMS) receiving extended dosing of rituximab (RTX) have exhibited no return of disease activity, which suggests that maintenance of deep depletion of circulating B cells is not necessary to ... ...
Abstract | Background and objectives: Patients with multiple sclerosis (PwMS) receiving extended dosing of rituximab (RTX) have exhibited no return of disease activity, which suggests that maintenance of deep depletion of circulating B cells is not necessary to maintain the efficacy of RTX in MS. Methods: This was a prospective monocentric observational study including all consecutive PwMS who started or continued RTX after 2019, when the medical staff decided to extend the dosing interval up to 24 months for all patients. Circulating B-cell subsets were monitored regularly and systematically in case of relapse. The first extended interval was analyzed. Results: We included 236 PwMS (81% with relapsing-remitting MS; mean [SD] age 43 [12] years; median [range] EDSS score 4 [0-8]; mean relapse rate during the year before RTX start 1.09 [0.99]; 41.5% with MRI activity). The median number of RTX infusions before extension was 4 (1-13). At the time of the analysis, the median delay in dosing was 17 months (8-39); the median proportion of circulating CD19 Discussion: The efficacy of RTX outlasted substantial reconstitution of circulating B cells in PwMS, which suggests that renewal of the immune system underlies the prolonged effect of RTX in MS. These findings suggest that extended interval dosing of RTX that leads to a significant reconstitution of circulating B cells is safe in PwMS, could reduce the risk of infection, and could improve vaccine efficacy. |
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Mesh-Begriff(e) | Adult ; Humans ; B-Lymphocytes ; Memory B Cells ; Multiple Sclerosis/drug therapy ; Prospective Studies ; Rituximab/pharmacology ; Middle Aged |
Chemische Substanzen | Rituximab (4F4X42SYQ6) |
Sprache | Englisch |
Erscheinungsdatum | 2023-08-21 |
Erscheinungsland | United States |
Dokumenttyp | Observational Study ; Journal Article |
ZDB-ID | 2767740-0 |
ISSN | 2332-7812 ; 2332-7812 |
ISSN (online) | 2332-7812 |
ISSN | 2332-7812 |
DOI | 10.1212/NXI.0000000000200152 |
Datenquelle | MEDical Literature Analysis and Retrieval System OnLINE |
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