PMID- 30539030
OWN - NLM
STAT- MEDLINE
DCOM- 20190111
LR  - 20220331
IS  - 2314-7156 (Electronic)
IS  - 2314-8861 (Print)
IS  - 2314-7156 (Linking)
VI  - 2018
DP  - 2018
TI  - Safety and Efficacy of Rituximab in Multiple Sclerosis: A Retrospective 
      Observational Study.
PG  - 9084759
LID - 10.1155/2018/9084759 [doi]
LID - 9084759
AB  - OBJECTIVE: To evaluate the efficacy and safety of rituximab in multiple sclerosis 
      in a clinical practice setting. METHODS: Clinical data for all adult patients 
      with multiple sclerosis (MS) treated with off-label rituximab at a single MS 
      center in Lebanon between March 2008 and April 2017 were retrospectively 
      collected from medical charts. The main efficacy outcomes assessed were 
      annualized relapse rate (ARR) and proportion of patients free from relapses, 
      disability progression, or magnetic resonance imaging (MRI) activity. RESULTS: A 
      total of 89 rituximab-treated patients were included: 59 relapsing-remitting MS 
      (RRMS) and 30 progressive MS (PMS). Patients were treated with 1000 or 2000 mg 
      rituximab IV every 6-12 months for a mean duration of 22.2 +/- 24.8 months. The 
      subjects were 65.2% females with a mean age of 40.5 +/- 12.3 years and a mean 
      disease duration of 7.9 +/- 6.2 years. During treatment, the ARR decreased from 
      1.07 at baseline to 0.11 in RRMS (p < 0.0001) and from 0.25 to 0.16 in PMS 
      patients (p = 0.593). The mean Expanded Disability Status Scale (EDSS) remained 
      unchanged in both RRMS and PMS patients. Between baseline and the last follow-up, 
      the percent of patients free from any new MRI lesions increased from 18.6% to 
      92.6% in the RRMS group and from 43.3% to 82% in the PMS group. No evidence of 
      disease activity (NEDA) was achieved in 74% of patients at 1 year of treatment. A 
      total of 64 adverse events (AEs) (71.9%) were recorded with the most common being 
      infusion-related reactions in 25.8% of patients, all mild in nature. Two of our 
      rituximab-treated patients experienced serious AEs requiring surgical 
      interventions: pyoderma gangrenosum vaginalis with perianal abscess and fistula 
      and an increase in the size of a meningioma. No case of progressive multifocal 
      leukoencephalopathy (PML) was detected. CONCLUSION: In our real-world cohort, 
      rituximab was well-tolerated and effective in reducing relapse rate and 
      disability progression in relapsing-remitting and progressive MS patients.
FAU - Yamout, Bassem I
AU  - Yamout BI
AD  - Nehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut 
      Medical Center, Beirut, Lebanon.
FAU - El-Ayoubi, Nabil K
AU  - El-Ayoubi NK
AD  - Nehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut 
      Medical Center, Beirut, Lebanon.
FAU - Nicolas, Johny
AU  - Nicolas J
AD  - Faculty of Medicine, American University of Beirut, Lebanon.
FAU - El Kouzi, Yehya
AU  - El Kouzi Y
AD  - Nehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut 
      Medical Center, Beirut, Lebanon.
FAU - Khoury, Samia J
AU  - Khoury SJ
AUID- ORCID: 0000-0003-3198-6063
AD  - Nehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut 
      Medical Center, Beirut, Lebanon.
FAU - Zeineddine, Maya M
AU  - Zeineddine MM
AD  - Nehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut 
      Medical Center, Beirut, Lebanon.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20181112
PL  - Egypt
TA  - J Immunol Res
JT  - Journal of immunology research
JID - 101627166
RN  - 0 (Antigens, CD20)
RN  - 0 (Immunologic Factors)
RN  - 4F4X42SYQ6 (Rituximab)
SB  - IM
MH  - Adult
MH  - Antigens, CD20/immunology
MH  - Brain/diagnostic imaging/*pathology
MH  - Cohort Studies
MH  - Disease Progression
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Immunologic Factors/adverse effects/*therapeutic use
MH  - Injection Site Reaction/etiology
MH  - Lebanon
MH  - Magnetic Resonance Imaging
MH  - Male
MH  - Middle Aged
MH  - Multiple Sclerosis/*diet therapy
MH  - Off-Label Use
MH  - Retrospective Studies
MH  - Rituximab/adverse effects/*therapeutic use
PMC - PMC6260423
EDAT- 2018/12/13 06:00
MHDA- 2019/01/12 06:00
PMCR- 2018/11/12
CRDT- 2018/12/13 06:00
PHST- 2018/05/09 00:00 [received]
PHST- 2018/08/31 00:00 [revised]
PHST- 2018/09/16 00:00 [accepted]
PHST- 2018/12/13 06:00 [entrez]
PHST- 2018/12/13 06:00 [pubmed]
PHST- 2019/01/12 06:00 [medline]
PHST- 2018/11/12 00:00 [pmc-release]
AID - 10.1155/2018/9084759 [doi]
PST - epublish
SO  - J Immunol Res. 2018 Nov 12;2018:9084759. doi: 10.1155/2018/9084759. eCollection 
      2018.