Effectiveness of low dose of rituximab compared with azathioprine in Chinese patients with neuromyelitis optica: an over 2-year follow-up study
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Neuromyelitis optical (NMO) and neuromyelitis optical spectrum disorder (NMOSD) are inflammatory autoimmune demyelination diseases affecting the central nervous system. We investigated the efficiency of low-dose rituximab treatment in 31 Chinese patients with NMO/NMOSD across a median period of 2.29 ± 0.97 years and azathioprine combined with corticosteroid treatment in 34 Chinese patients with NMO/NMOSD across a median period of 2.61 ± 0.94 years. Among the rituximab-treated patients, the mean Expanded Disability Status Scale (EDSS) was 5.62 ± 1.35 before treatment and 4.48 ± 0.78 at last follow-up, and the mean annualized relapse rate (ARR) was 1.39 ± 0.42 before treatment and 0.03 ± 0.13 at last follow-up. Among the azathioprine-treated patients, the mean EDSS was 5.63 ± 1.29 before treatment and 5.05 ± 1.00 at last follow-up, and the mean ARR was 1.28 ± 0.34 before treatment and 0.49 ± 0.21 at last follow-up. In this study, we showed that using low-dosage rituximab could benefit Chinese patients with NMO by reducing the new occurrence of relapses dramatically. Compared with the azathioprine-treated patients, we concluded that rituximab is more effective in preventing NMO relapse and could improve the symptoms.
KeywordsNeuromyelitis optical Low-dosage rituximab Azathioprine Efficiency
This work was supported by a Grant from the Natural Science Foundation of Shanxi Province, China (Grant Number 2013011052-3).
MZ formulated the study concept, supervised the execution of the study, provided the funding, and wrote the manuscript. CZ and PB recruited the patients, executed the treatment regimen, assessed the patients, and analyzed the patient data during therapy. HX participated in the manuscript preparation. GW processed the blood samples, performed the flow cytometry, and analyzed the laboratory results.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no financial and personal relationships with other people or organizations that can inappropriately influence our work. There is no professional or other personal interest of any nature or kind in any product, service or company that could be construed as influencing the position presented in, or the review of, the manuscript.
All procedures performed in studies involving human participants were approved by the Shanxi Medical University Ethical Review Board. This article does not contain any studies with animals performed by any of the authors.
Informed consent was obtained from all individual participants included in the study.