Efficacy and safety of rituximab in multiple sclerosis and neuromyelitis optica spectrum disorder
Abstract In Thailand, resource limitations lead many multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) patients to use off-label immunosuppressants. This study assesses the efficacy and safety of rituximab (RTX) with a CD19-based reinfusion regimen among Thai MS and NMOSD pa...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2024-02-01
|
| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-024-53838-y |
| _version_ | 1797274689797619712 |
|---|---|
| author | Tatchaporn Ongphichetmetha Jiraporn Jitprapaikulsan Sasitorn Siritho Natthapon Rattanathamsakul Thammachet Detweeratham Naraporn Prayoonwiwat |
| author_facet | Tatchaporn Ongphichetmetha Jiraporn Jitprapaikulsan Sasitorn Siritho Natthapon Rattanathamsakul Thammachet Detweeratham Naraporn Prayoonwiwat |
| author_sort | Tatchaporn Ongphichetmetha |
| collection | DOAJ |
| description | Abstract In Thailand, resource limitations lead many multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) patients to use off-label immunosuppressants. This study assesses the efficacy and safety of rituximab (RTX) with a CD19-based reinfusion regimen among Thai MS and NMOSD patients. A retrospective review of patients at the Faculty of Medicine Siriraj Hospital from January 1994 to April 2023 was conducted. The primary outcome assessed was the change in annualized relapse rate (ARR) for patients using RTX for over a year. Secondary outcomes included changes in the Expanded Disability Status Scale (EDSS) scores, time to the first relapse after RTX initiation for patients using RTX for over a year, and an evaluation of the safety of RTX. The study encompassed 36 MS and 39 NMOSD patients. A majority of patients (91.7% of MS and 79.5% of NMOSD) experienced no relapses during a median follow-up of 30 months (Interquartile range [IQR] 20–46) and 31 months (IQR 23–41), respectively. The median ARR significantly decreased in both MS (from 0.77 [IQR 0.42–1.83] to 0 [IQR 0–0], p < 0.001) and NMOSD (from 0.92 [IQR 0.68–1.78] to 0 [IQR 0–0.17], p < 0.001) patients after switching to RTX, with no difference between those following a fixed 6-month time point regimen and a CD19-based reinfusion regimen. Median EDSS scores improved significantly at the last follow-up visit in both groups. The mean time to the first subsequent relapse was 8.3 ± 3.0 months in MS and 6.8 ± 1.7 months in NMOSD. Mild adverse drug reactions occurred in 44% of patients. RTX effectively prevents relapses in Thai MS and NMOSD patients, with no observed serious adverse drug reactions. |
| first_indexed | 2024-03-07T15:02:50Z |
| format | Article |
| id | doaj.art-e82009ea3de940e1adb5366fd02decf2 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-03-07T15:02:50Z |
| publishDate | 2024-02-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-e82009ea3de940e1adb5366fd02decf22024-03-05T19:05:15ZengNature PortfolioScientific Reports2045-23222024-02-0114111210.1038/s41598-024-53838-yEfficacy and safety of rituximab in multiple sclerosis and neuromyelitis optica spectrum disorderTatchaporn Ongphichetmetha0Jiraporn Jitprapaikulsan1Sasitorn Siritho2Natthapon Rattanathamsakul3Thammachet Detweeratham4Naraporn Prayoonwiwat5Division of Neurology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol UniversityDivision of Neurology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol UniversitySiriraj Neuroimmunology Center, Faculty of Medicine Siriraj Hospital, Mahidol UniversityDivision of Neurology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol UniversityDivision of Neurology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol UniversityDivision of Neurology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol UniversityAbstract In Thailand, resource limitations lead many multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) patients to use off-label immunosuppressants. This study assesses the efficacy and safety of rituximab (RTX) with a CD19-based reinfusion regimen among Thai MS and NMOSD patients. A retrospective review of patients at the Faculty of Medicine Siriraj Hospital from January 1994 to April 2023 was conducted. The primary outcome assessed was the change in annualized relapse rate (ARR) for patients using RTX for over a year. Secondary outcomes included changes in the Expanded Disability Status Scale (EDSS) scores, time to the first relapse after RTX initiation for patients using RTX for over a year, and an evaluation of the safety of RTX. The study encompassed 36 MS and 39 NMOSD patients. A majority of patients (91.7% of MS and 79.5% of NMOSD) experienced no relapses during a median follow-up of 30 months (Interquartile range [IQR] 20–46) and 31 months (IQR 23–41), respectively. The median ARR significantly decreased in both MS (from 0.77 [IQR 0.42–1.83] to 0 [IQR 0–0], p < 0.001) and NMOSD (from 0.92 [IQR 0.68–1.78] to 0 [IQR 0–0.17], p < 0.001) patients after switching to RTX, with no difference between those following a fixed 6-month time point regimen and a CD19-based reinfusion regimen. Median EDSS scores improved significantly at the last follow-up visit in both groups. The mean time to the first subsequent relapse was 8.3 ± 3.0 months in MS and 6.8 ± 1.7 months in NMOSD. Mild adverse drug reactions occurred in 44% of patients. RTX effectively prevents relapses in Thai MS and NMOSD patients, with no observed serious adverse drug reactions.https://doi.org/10.1038/s41598-024-53838-y |
| spellingShingle | Tatchaporn Ongphichetmetha Jiraporn Jitprapaikulsan Sasitorn Siritho Natthapon Rattanathamsakul Thammachet Detweeratham Naraporn Prayoonwiwat Efficacy and safety of rituximab in multiple sclerosis and neuromyelitis optica spectrum disorder Scientific Reports |
| title | Efficacy and safety of rituximab in multiple sclerosis and neuromyelitis optica spectrum disorder |
| title_full | Efficacy and safety of rituximab in multiple sclerosis and neuromyelitis optica spectrum disorder |
| title_fullStr | Efficacy and safety of rituximab in multiple sclerosis and neuromyelitis optica spectrum disorder |
| title_full_unstemmed | Efficacy and safety of rituximab in multiple sclerosis and neuromyelitis optica spectrum disorder |
| title_short | Efficacy and safety of rituximab in multiple sclerosis and neuromyelitis optica spectrum disorder |
| title_sort | efficacy and safety of rituximab in multiple sclerosis and neuromyelitis optica spectrum disorder |
| url | https://doi.org/10.1038/s41598-024-53838-y |
| work_keys_str_mv | AT tatchapornongphichetmetha efficacyandsafetyofrituximabinmultiplesclerosisandneuromyelitisopticaspectrumdisorder AT jirapornjitprapaikulsan efficacyandsafetyofrituximabinmultiplesclerosisandneuromyelitisopticaspectrumdisorder AT sasitornsiritho efficacyandsafetyofrituximabinmultiplesclerosisandneuromyelitisopticaspectrumdisorder AT natthaponrattanathamsakul efficacyandsafetyofrituximabinmultiplesclerosisandneuromyelitisopticaspectrumdisorder AT thammachetdetweeratham efficacyandsafetyofrituximabinmultiplesclerosisandneuromyelitisopticaspectrumdisorder AT narapornprayoonwiwat efficacyandsafetyofrituximabinmultiplesclerosisandneuromyelitisopticaspectrumdisorder |