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Efficacy and safety of rituximab in relapsing and progressive multiple sclerosis: a hospital-based study

Journal of Neurology volume 265, pages 1690–1697 (2018)Cite this article

Abstract

Introduction

Rituximab is considered as a potential therapeutic option in relapsing-remitting (RRMS) and progressive forms (PMS) of multiple sclerosis (MS).

Objective

To investigate the effectiveness and safety of rituximab in MS.

Patients and methods

Observational study of effectiveness (clinical and radiological) and safety of rituximab in RRMS and PMS.

Results

A total of 90 rituximab-treated patients were collected: 31 RRMS and 59 PMS All patients had an active disease despite standard treatment. The annualized relapse rate (ARR) the year before rituximab was 0.86, 53.3% of patients had gadolinium enhanced lesion, and mean Expanded Disability Status Scale (EDSS) had increased from 4.2 to 4.9. During treatment, the ARR was reduced an 88.4% (p < 0.001). A significant decrease of EDSS to 4.6 was observed (p = 0.01) after 1 year of treatment, which remained stable during the second year in both groups. There was no evidence of disease activity in 70% of total sample, 74.2% of RRMS, and 67% of the PMS patients. Infusion-related symptoms were the most prevalent side effect (18.8%) and most were mild. Three thrombotic events were detected.

Conclusion

Rituximab could be an effective and safe treatment in aggressive RRMS. Some selected PMS patients could also benefit from this treatment.

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Author information

Affiliations

  1. Unit of Neuroimmunology, Department of Neurology, Hospital Universitari i Politècnic La Fe, 106 Avenue Fernando Abril Martorell, 46026, Valencia, Spain

    Carmen Alcalá, F. Pérez-Miralles, S. Gil-Perotín, I. Boscá & B. Casanova

  2. Unit of Neuroimmunology, Department of Neurology, Hospital Clínico Universitario, Valencia, Spain

    F. Gascón, A. Navarré & F. Coret

Authors
  1. Carmen Alcalá
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  2. F. Gascón
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  3. F. Pérez-Miralles
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  4. S. Gil-Perotín
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  5. A. Navarré
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  6. I. Boscá
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  7. F. Coret
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  8. B. Casanova
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Corresponding author

Correspondence to Carmen Alcalá.

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Conflicts of interest

The authors declare that they have no conflict of interest.

Ethical standard

All patients included in the study acceded to donate and signed a specific informed consent and all research was conducted following legal and ethical requirements at the Research Institute of the Hospital La Fe and was approved by its Institutional Review Board.

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Cite this article

Alcalá, C., Gascón, F., Pérez-Miralles, F. et al. Efficacy and safety of rituximab in relapsing and progressive multiple sclerosis: a hospital-based study. J Neurol 265, 1690–1697 (2018). https://doi.org/10.1007/s00415-018-8899-3

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  • DOI: https://doi.org/10.1007/s00415-018-8899-3

Keywords

  • Multiple sclerosis
  • Relapsing-remitting multiple sclerosis
  • Progressive multiple sclerosis
  • Treatment
  • Rituximab
  • Anti-CD20 monoclonal antibody