A previous 2-year analysis of repeated Rituximab ( MabThera, Rituxan ) treatment in patients with neuromyelitis optica ( NMO ) revealed significant improvements in relapse rates and disability.
Researchers have reported the findings from the longest follow-up of Rituximab treatment in NMO, which provide reassurance regarding the long-term efficacy and safety of Rituximab in NMO.
Thirty patients with relapsing NMO or NMO spectrum disorder ( NMOSD ) in an institutional referral Center for multiple sclerosis were studied retrospectively.
After induction therapy, a single infusion of Rituximab ( 375 mg/m2 ) as maintenance therapy was administered whenever the frequency of reemerging CD27+ memory B cells in peripheral blood mononuclear cells, as measured with flow cytometry, exceeded 0.05% in the first 2 years and 0.1% thereafter.
Of 30 patients, 26 ( 87% ) exhibited a marked reduction in annualized relapse rate ( ARR ) over 5 years ( mean pretreatment vs posttreatment ARR, 2.4 vs 0.3 ).
Eighteen patients ( 60% ) became relapse free after Rituximab treatment. In 28 patients ( 93% ), the disability was either improved or stabilized after Rituximab treatment.
No serious adverse events leading to discontinuation were observed during follow-up.
In conclusion, repeated treatment with Rituximab in patients with NMOSD over a 5-period, using an individualized dosing schedule according to the frequency of reemerging CD27+ memory B cells, leads to a sustained clinical response with no new adverse events. ( Xagena )
Kim SH et al, JAMA Neurol 2013;70:1110-1117