[Pubmed] Long-term efficacy and safety of low-dose rituximab in patients with refractory myasthenia gravis

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Eur Neurol. 2023 Sep 30. doi: 10.1159/000534336. Online ahead of print.

ABSTRACT

Introduction Rituximab is a monoclonal chimeric antibody against CD20+ B cells. We aimed to assess the long-term efficacy and safety of CD20+ B cell-guided treatment with low-dose rituximab in refractory myasthenia gravis patients. Methods Patients with refractory myasthenia gravis treated with rituximab for more than 2 years were included. Rituximab was administered when CD20+ B cells were greater than 1%. We analysed the efficacy of rituximab, treatment interval, side effects, prognosis and treatment course. Results A total of 22 patients were included. All patients received 2-12 doses of rituximab, and the median follow-up time was 48.5 months. The scores of the Myasthenia Gravis Activities of Daily Living and Myasthenia Gravis Composite were significantly lower than those at baseline (P < 0.05). MGFA-PIS was significantly improved in 21 (95.45%) patients and 14 (63.64%) patients have reached MGFA-PIS minimal manifestations. The average daily dose of prednisone and pyridostigmine bromide and the proportion of immunosuppressants were significantly lower (P < 0.05). Seven patients suffered from 14 worsenings. Eight patients terminated rituximab due to good efficacy. Most patients tolerated well to rituximab but one patient had opportunistic infection and hypogammaglobulinemia. One patient had an intracranial mass. Conclusion Long-term CD20+ B-cell-guided low-dose rituximab showed good efficacy and tolerance in patients with refractory myasthenia gravis.

PMID:37778340 | DOI:10.1159/000534336


Source: https://pubmed.ncbi.nlm.nih.gov/3777834 ... t6+86293ac