Long-Term Remission With Low-Dose Rituximab in Myasthenia Gravis: A Retrospective Study.

Q3 Medicine

Journal of Clinical Neuromuscular Disease Pub Date : 2022-09-01 DOI:10.1097/CND.0000000000000420

Juan I Castiglione, Alberto D Rivero, Fabio Barroso, Patricio Brand, Andrea Lautre, Alejandro A Kohler

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引用次数: 2

Abstract

Objetive: Rituximab (RTX) is a therapeutic option, for patients with myasthenia gravis (MG) not responding to conventional immunosuppressive treatment. In this cohort, we evaluated long-term efficacy of RTX in the treatment of refractory generalized MG.

Methods: A retrospective study was performed in adult patients with refractory generalized MG and at least 24 months of follow-up, between January/2015 and October/2021. The Myasthenia Gravis Status and Treatment Intensity Score was used to assess outcomes, and CD19/CD20+ B-cell counts were monitored.

Results: Sixteen patients with MG (8 antiacetylcholine receptor+ and 8 muscle-specific antikinase+; mean age 45.5 ± 16.2 years) treated with low-dose RTX protocols were included. CD19/CD20 levels remained undetectable 12 months after induction, and no new relapses were observed during follow-up.

Conclusions: Low-dose RTX infusions were sufficient to achieve undetectable CD19/20 cell counts and sustained clinical remission. In low and middle-income countries, the impact of low-dose RTX therapy represents a paradigm shift in decision-making for long-term treatment.

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低剂量利妥昔单抗治疗重症肌无力长期缓解:一项回顾性研究。

目的:对于常规免疫抑制治疗无效的重症肌无力患者，利妥昔单抗(RTX)是一种治疗选择。在这个队列中，我们评估了RTX治疗难治性广泛性MG的长期疗效。方法:在2015年1月至2021年10月期间，对难治性全身性MG成年患者进行回顾性研究，随访至少24个月。重症肌无力状态和治疗强度评分用于评估结果，并监测CD19/CD20+ b细胞计数。结果:16例MG(8抗乙酰胆碱受体+和8例肌肉特异性抗激酶+;平均年龄(45.5±16.2岁)，接受低剂量RTX治疗。诱导后12个月仍未检测到CD19/CD20水平，随访期间未观察到新的复发。结论:低剂量RTX输注足以达到无法检测到的CD19/20细胞计数和持续的临床缓解。在低收入和中等收入国家，低剂量RTX治疗的影响代表了长期治疗决策的范式转变。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Neuromuscular Disease Medicine-Medicine (all)

CiteScore

1.60

自引率

0.00%

发文量

期刊介绍： Journal of Clinical Neuromuscular Disease provides original articles of interest to physicians who treat patients with neuromuscular diseases, including disorders of the motor neuron, peripheral nerves, neuromuscular junction, muscle, and autonomic nervous system. Each issue highlights the most advanced and successful approaches to diagnosis, functional assessment, surgical intervention, pharmacologic treatment, rehabilitation, and more.