[pubmed] Short Term Effect of Low-dose Rituximab on Myasthenia Gravis with Muscle-specific Tyrosine Kinase Antibody

[RSS-Bot]

Muscle Nerve. 2021 Mar 21. doi: 10.1002/mus.27233. Online ahead of print.

ABSTRACT

INTRODUCTION/AIMS: The study aims to investigate the short-term efficacy of low-dose rituximab and its effect on immunological biomarker levels in myasthenia gravis patients with antibodies against muscle-specific tyrosine kinase (MuSK-MG).

METHODS: Twelve MuSK-MG patients were enrolled in this prospective, open-label, self-controlled pilot study. Clinical severity was evaluated at baseline and 6 months after a single rituximab treatment (600mg). B lymphocyte subtypes, MuSK antibody titers together with levels of immunoglobulins, serum B cell activating factor (BAFF), a proliferation-inducing ligand (APRIL), soluble CD40L and 4 exosomal microRNAs were evaluated. A correlation matrix to reveal pairwise relationships among above variables was also generated.

RESULTS: The single rituximab treatment significantly lowered the clinical severity scores and reduced daily dosage of prednisone (p=0.032) at 6 months. MuSK antibody titers decreased (p=0.035) without significant changes in immunoglobin levels. Serum BAFF level increased (p=0.010), which negatively correlated with the percentages of B cells in lymphocytes as well as clinical severity. Additionally, serum exosomal miR-151a-3p showed a reduction of 28.1% (p=0.031).

DISCUSSION: We confirmed the clinical efficacy of low-dose rituximab in MuSK- MG, accompanied by a decrease in MuSK antibody titers and an increase in serum BAFF. Serum BAFF levels negatively correlated with B cell counts as well as clinical severity.

PMID:33745138 | DOI:10.1002/mus.27233


Source: https://pubmed.ncbi.nlm.nih.gov/3374513 ... 6&v=2.14.3