Efficacy and Safety of Rituximab in patients with Neuromyelitis Optica Spectrum Disorders: A prospective observation in Iranian Cases.
Background: Rituximab has been used successfully in the recent years for treatment of neuromyelitis optica spectrum disorders (NMOSD). However, a uniform treatment protocol for maintenance therapy and the best interval for evaluation and retreatment have not been postulated. We evaluated the efficac...
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| Format: | Article |
| Language: | English |
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Babol University of Medical Sciences
2020-03-01
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| Series: | Caspian Journal of Internal Medicine |
| Subjects: | |
| Online Access: | http://caspjim.com/article-1-1877-en.html |
| _version_ | 1819171205434834944 |
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| author | Maral Seyed Ahadi Abdorreza Naser Moghadasi Nasrin Asgari Mohammad Ali Sahraian |
| author_facet | Maral Seyed Ahadi Abdorreza Naser Moghadasi Nasrin Asgari Mohammad Ali Sahraian |
| author_sort | Maral Seyed Ahadi |
| collection | DOAJ |
| description | Background: Rituximab has been used successfully in the recent years for treatment of neuromyelitis optica spectrum disorders (NMOSD). However, a uniform treatment protocol for maintenance therapy and the best interval for evaluation and retreatment have not been postulated. We evaluated the efficacy and safety of rituximab treatment as second line therapy, in Iranian patients with refractory NMOSD, based on annualized relapse rate (ARR) and expanded disability status scale (EDSS).
Methods: In this prospective before-after study, a total of 18 patients were treated with a loading dose of rituximab (375 mg/m2 weekly in 4 consecutive weeks). Flow cytometric determination of CD19+ B cell in peripheral blood sample was carried every 6 weeks and patients were re-treated based on B cell repopulation with a single dose of 375 mg/m2. Wilcoxon signed rank test was used to evaluate the ARR and EDSS before and after treatment. A p-value of <0.05 was considered statistically significant.
Results: Of the 18 patients, 10 (55.5%) were relapse-free during the period of follow up. The EDSS scores were reduced in nine (50%) patients and stable in the remaining nine (50%). The mean EDSS score before and after treatment were 4.1±0.4 and 3.7±0.3, respectively, which was statistically significant. There was also a statistically significant reduction in median ARR after treatment (1.48 (range 0.47-5) vs. 0 (range 0-2)). Rituximab administration did not have significant adverse effect in 94% of patients.
Conclusion: Repeated treatment with Rituximab is an effective and well-tolerated treatment in refractory NMOSD. |
| first_indexed | 2024-12-22T19:47:35Z |
| format | Article |
| id | doaj.art-e897156b8c4242908f018d11a649f2ba |
| institution | Directory Open Access Journal |
| issn | 2008-6164 2008-6172 |
| language | English |
| last_indexed | 2024-12-22T19:47:35Z |
| publishDate | 2020-03-01 |
| publisher | Babol University of Medical Sciences |
| record_format | Article |
| series | Caspian Journal of Internal Medicine |
| spelling | doaj.art-e897156b8c4242908f018d11a649f2ba2022-12-21T18:14:39ZengBabol University of Medical SciencesCaspian Journal of Internal Medicine2008-61642008-61722020-03-01112155162Efficacy and Safety of Rituximab in patients with Neuromyelitis Optica Spectrum Disorders: A prospective observation in Iranian Cases.Maral Seyed Ahadi0Abdorreza Naser Moghadasi1Nasrin Asgari2Mohammad Ali Sahraian3 Multiple Sclerosis Research Center; Neuroscience institute; Tehran University of Medical Sciences; Tehran; Iran Multiple Sclerosis Research Center; Neuroscience institute; Tehran University of Medical Sciences; Tehran; Iran Institutes of Regional Health Research and Molecular Medicine, University of Southern Denmark. Multiple Sclerosis Research Center; Neuroscience institute; Tehran University of Medical Sciences; Tehran; Iran Background: Rituximab has been used successfully in the recent years for treatment of neuromyelitis optica spectrum disorders (NMOSD). However, a uniform treatment protocol for maintenance therapy and the best interval for evaluation and retreatment have not been postulated. We evaluated the efficacy and safety of rituximab treatment as second line therapy, in Iranian patients with refractory NMOSD, based on annualized relapse rate (ARR) and expanded disability status scale (EDSS). Methods: In this prospective before-after study, a total of 18 patients were treated with a loading dose of rituximab (375 mg/m2 weekly in 4 consecutive weeks). Flow cytometric determination of CD19+ B cell in peripheral blood sample was carried every 6 weeks and patients were re-treated based on B cell repopulation with a single dose of 375 mg/m2. Wilcoxon signed rank test was used to evaluate the ARR and EDSS before and after treatment. A p-value of <0.05 was considered statistically significant. Results: Of the 18 patients, 10 (55.5%) were relapse-free during the period of follow up. The EDSS scores were reduced in nine (50%) patients and stable in the remaining nine (50%). The mean EDSS score before and after treatment were 4.1±0.4 and 3.7±0.3, respectively, which was statistically significant. There was also a statistically significant reduction in median ARR after treatment (1.48 (range 0.47-5) vs. 0 (range 0-2)). Rituximab administration did not have significant adverse effect in 94% of patients. Conclusion: Repeated treatment with Rituximab is an effective and well-tolerated treatment in refractory NMOSD.http://caspjim.com/article-1-1877-en.htmlneuromyelitis optica spectrum disordersrituximabcd19+ b celledssannualized relapse rate |
| spellingShingle | Maral Seyed Ahadi Abdorreza Naser Moghadasi Nasrin Asgari Mohammad Ali Sahraian Efficacy and Safety of Rituximab in patients with Neuromyelitis Optica Spectrum Disorders: A prospective observation in Iranian Cases. Caspian Journal of Internal Medicine neuromyelitis optica spectrum disorders rituximab cd19+ b cell edss annualized relapse rate |
| title | Efficacy and Safety of Rituximab in patients with Neuromyelitis Optica Spectrum Disorders: A prospective observation in Iranian Cases. |
| title_full | Efficacy and Safety of Rituximab in patients with Neuromyelitis Optica Spectrum Disorders: A prospective observation in Iranian Cases. |
| title_fullStr | Efficacy and Safety of Rituximab in patients with Neuromyelitis Optica Spectrum Disorders: A prospective observation in Iranian Cases. |
| title_full_unstemmed | Efficacy and Safety of Rituximab in patients with Neuromyelitis Optica Spectrum Disorders: A prospective observation in Iranian Cases. |
| title_short | Efficacy and Safety of Rituximab in patients with Neuromyelitis Optica Spectrum Disorders: A prospective observation in Iranian Cases. |
| title_sort | efficacy and safety of rituximab in patients with neuromyelitis optica spectrum disorders a prospective observation in iranian cases |
| topic | neuromyelitis optica spectrum disorders rituximab cd19+ b cell edss annualized relapse rate |
| url | http://caspjim.com/article-1-1877-en.html |
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