6533b81ffe1ef96bd1277367
RESEARCH PRODUCT
Treatment of multiple sclerosis with rituximab: A multicentric Italian–Swiss experience
Antonio GalloGianmarco AbbadessaChiara ZeccaGiancarlo CogheGiuseppe SalemiAntonio UccelliMarco CapobiancoStefania BaroneRosaria SaccoLorena LoreficeClaudia MechiGiorgia MataluniElio PrestipinoJessica FrauClaudio GobbiAlessandro BarilaroGiorgia Teresa ManiscalcoErica CurtiE. MagnaniBahia HakikiMaria MalentacchiSimona BonavitaAlessia Di SapioFrancesca BovisMaria CellerinoFranco GranellaRoberta Lanzillo 2Anna Maria RepiceMarcello De AngelisIsabella MaraffiLaura BrambillaGiuseppe FenuElisabetta SignorielloAlessio SignoriPaola CavallaMaria Pia SormaniAgostino NozzolilloGiacomo BoffaSimona MalucchiMaria Pia AmatoGiovanni NoviSabrina RealmutoFrancesca SperliIlaria MaiettaVincenzo Brescia Morrasubject
Multiple Sclerosismedicine.drug_classLymphocyte depletionrelapsing–remittingMonoclonal antibodyPrimary progressive03 medical and health sciences0302 clinical medicineMultiple Sclerosis Relapsing-Remittingreal lifemedicineHumansImmunologic Factors030212 general & internal medicineSecondary progressiveRetrospective Studiesprimary progressivebusiness.industryMultiple sclerosisRituximab; multiple sclerosis; primary progressive; real life; relapsing–remitting; secondary progressiveTreatment optionsmedicine.diseaseNeurologyRelapsing remittingItalymultiple sclerosiImmunologysecondary progressiveRituximabSettore MED/26 - NeurologiaNeurology (clinical)businessRituximab030217 neurology & neurosurgerySwitzerlandmedicine.drugdescription
Background: Rituximab, an anti-CD20 monoclonal antibody leading to B lymphocyte depletion, is increasingly used as an off-label treatment option for multiple sclerosis (MS). Objective: To investigate the effectiveness and safety of rituximab in relapsing–remitting (RR) and progressive MS. Methods: This is a multicenter, retrospective study on consecutive MS patients treated off-label with rituximab in 22 Italian and 1 Swiss MS centers. Relapse rate, time to first relapse, Expanded Disability Status Scale (EDSS) progression, incidence of adverse events, and radiological outcomes from 2009 to 2019 were analyzed. Results: A total of 355/451 enrolled subjects had at least one follow-up visit and were included in the outcome analysis. Annualized relapse rate significantly decreases after rituximab initiation versus the pre-rituximab start year in RRMS (from 0.86 to 0.09, p < .0001) and in secondary-progressive (SP) MS (from 0.34 to 0.06, p < .0001) and had a slight decrease in primary-progressive (PP) MS patients (from 0.12 to 0.07, p = 0.45). After 3 years from rituximab start, the proportion of patients with a confirmed EDSS progression was 14.6% in the RRMS group, 24.7% in the SPMS group, and 41.5% in the PPMS group. No major safety concerns arose. Conclusion: Consistently with other observational studies, our data show effectiveness of rituximab in reducing disease activity in patients with MS.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2020-01-01 |