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Impact of rituximab treatment regime on time to relapse in aquaporin-4 antibody positive neuromyelitis optica spectrum disorder.
Nasir, Moneeb; Hone, Luke; Tallantyre, Emma; Kelly, Patricia; Leite, Maria Isabel; Robertson, Neil; Bestwick, Jonathan; Huda, Saif; Palace, Jacqueline; Dobson, Ruth.
Afiliación
  • Nasir M; Department of Neurology, The Royal London Hospital, Barts Health NHS Trust, London, United Kingdom.
  • Hone L; Centre for Preventive Neurology, Queen Mary University London, London, United Kingdom.
  • Tallantyre E; Department of Neurology, University Hospital Wales, Cardiff, United Kingdom; Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, United Kingdom.
  • Kelly P; Department of Neurology, Walton Centre NHS Foundation Trust, Liverpool, United Kingdom.
  • Leite MI; Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, United Kingdom.
  • Robertson N; Department of Neurology, University Hospital Wales, Cardiff, United Kingdom; Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, United Kingdom.
  • Bestwick J; Centre for Preventive Neurology, Queen Mary University London, London, United Kingdom.
  • Huda S; Department of Neurology, Walton Centre NHS Foundation Trust, Liverpool, United Kingdom.
  • Palace J; Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, United Kingdom.
  • Dobson R; Department of Neurology, The Royal London Hospital, Barts Health NHS Trust, London, United Kingdom; Centre for Preventive Neurology, Queen Mary University London, London, United Kingdom. Electronic address: ruth.dobson@qmul.ac.uk.
Mult Scler Relat Disord ; 85: 105528, 2024 May.
Article en En | MEDLINE | ID: mdl-38479046
ABSTRACT

BACKGROUND:

Aquaporin-4 (AQP4) antibody associated neuromyelitis optica (NMOSD) requires long-term immunosuppression. Rituximab is increasingly used worldwide, however the optimal regime is not established.

METHODS:

We retrospectively examined different rituximab regimens in AQP4-NMOSD. Standard monotherapy (SM; 6 monthly infusions), SM plus oral steroids (SM+S), extended interval dosing (EID; guided by CD19 repopulation) and EID with oral steroids (EID+S) were compared. The primary outcome was time to first clinical relapse. Potential confounders including age, gender, number of previous relapses, and onset phenotype were included.

RESULTS:

77 patients were included 67 females, median onset age 35.6, median DSS at rituximab initiation 5.0. 39 were on SM+S, 20 SM, 6 EID, and 12 EID+S. 25/77 patients relapsed during a median follow-up of 44.0 months. No significant difference in time to first relapse was observed between any rituximab regimen. Pooled analyses to compare regimens that use standard monotherapy (SM and SM+S) against those that use extended interval dosing (EID and EID+S) showed no significant difference. Pooled analysis of regimens using steroids with those not using steroids also showed no significant difference. Adjusted Cox proportional hazard model revealed no significant difference between rituximab regimens or influence of demographic factors. 9 significant adverse events were recorded, 5 in the SM group and 4 in SM+S.

CONCLUSIONS:

This study provides some basis for further exploring EID as a viable option for long term treatment of AQP4-NMOSD. This may improve patient experience and consolidate use of hospital resources.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Recurrencia / Neuromielitis Óptica / Acuaporina 4 / Rituximab / Factores Inmunológicos Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Mult Scler Relat Disord Año: 2024 Tipo del documento: Article País de afiliación: Reino Unido Pais de publicación: Países Bajos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Recurrencia / Neuromielitis Óptica / Acuaporina 4 / Rituximab / Factores Inmunológicos Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Mult Scler Relat Disord Año: 2024 Tipo del documento: Article País de afiliación: Reino Unido Pais de publicación: Países Bajos