PMID- 34377385
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220429
IS  - 2040-6223 (Print)
IS  - 2040-6231 (Electronic)
IS  - 2040-6223 (Linking)
VI  - 12
DP  - 2021
TI  - Rituximab versus mitoxantrone: comparing effectiveness and safety in advanced 
      relapsing multiple sclerosis.
PG  - 20406223211024366
LID - 10.1177/20406223211024366 [doi]
LID - 20406223211024366
AB  - BACKGROUND: Rituximab (RTX), a CD20 depleting agent, is a frequently used 
      off-label treatment for multiple sclerosis (MS), while mitoxantrone (MTX) is 
      approved, albeit rarely used for active relapsing MS (RMS). However, 
      observational data comparing RTX and MTX effectiveness and safety are scarce. 
      OBJECTIVE: We aimed to compare effectiveness and safety of MTX and RTX in 
      patients with active RMS. METHODS: From combined retrospective clinical data of 
      three MS centers, we selected patients who had received at least one infusion of 
      RTX or MTX and had at least a 6-month clinical follow-up available. Treatment 
      groups were compared by propensity score (PS)-adjusted regression and inverse 
      PS-weighted generalized estimated equation models regarding disability 
      progression, relapse activity, and adverse events (AEs). RESULTS: We included 292 
      RMS patients (mean age 41.8 years, 71.6% female) who received RTX (119 patients, 
      mean age 36.8 years, 74.8% female) or MTX (173 patients mean age 45.3 years, 
      69.4% female). Using both PS methods, we did not find a significant effect 
      favoring RTX or MTX treatment regarding the probability of disability worsening 
      or relapse occurrence. However, RTX treatment was associated with a significantly 
      lower probability of severe AEs and AEs. CONCLUSIONS: RTX shows comparable 
      effectiveness but a favorable safety profile compared with MTX in active RMS.
CI  - (c) The Author(s), 2021.
FAU - Zrzavy, Tobias
AU  - Zrzavy T
AUID- ORCID: 0000-0001-8909-1591
AD  - Department of Neurology, Medical University of Vienna, Vienna, Austria.
FAU - Daniels, Esther
AU  - Daniels E
AD  - Department of Neurology, Rostock University Medical Center, Rostock, Germany.
FAU - Stuka, Niklas
AU  - Stuka N
AD  - Department of Neurology, Medical University of Vienna, Vienna, Austria.
FAU - Weber, Dennis
AU  - Weber D
AD  - Department of Neurology, Medical University of Vienna, Vienna, Austria.
FAU - Winkelmann, Alexander
AU  - Winkelmann A
AD  - Department of Neurology, Rostock University Medical Center, Rostock, Germany.
FAU - Rauschka, Helmut
AU  - Rauschka H
AD  - Department of Neurology, Karl Landsteiner Institute for Neuroimmunological and 
      Neurodegenerative Disorders and Diseases, Klinik Donaustadt, Vienna, Austria.
FAU - Hecker, Michael
AU  - Hecker M
AD  - Department of Neurology, Rostock University Medical Center, Rostock, Germany.
FAU - Aboulenein-Djamshidian, Fahmy
AU  - Aboulenein-Djamshidian F
AD  - Department of Neurology, Karl Landsteiner Institute for Neuroimmunological and 
      Neurodegenerative Disorders and Diseases, Klinik Donaustadt, Vienna, Austria.
FAU - Meister, Stefanie
AU  - Meister S
AD  - Department of Neurology, Rostock University Medical Center, Rostock, Germany.
FAU - Leutmezer, Fritz
AU  - Leutmezer F
AD  - Department of Neurology, Medical University of Vienna, Vienna, Austria.
FAU - Berger, Thomas
AU  - Berger T
AD  - Department of Neurology, Medical University of Vienna, Vienna, Austria.
FAU - Bsteh, Gabriel
AU  - Bsteh G
AD  - Department of Neurology, Medical University of Vienna, Waehringer Guertel 18-20, 
      Vienna, 1090, Austria.
FAU - Zettl, Uwe Klaus
AU  - Zettl UK
AD  - Department of Neurology, Rostock University Medical Center, Rostock, Germany.
FAU - Rommer, Paulus
AU  - Rommer P
AD  - Department of Neurology, Medical University of Vienna, Vienna, Austria Department 
      of Neurology, Rostock University Medical Center, Rostock, Germany.
LA  - eng
PT  - Journal Article
DEP - 20210728
PL  - United States
TA  - Ther Adv Chronic Dis
JT  - Therapeutic advances in chronic disease
JID - 101532140
EIN - Ther Adv Chronic Dis. 2021 Sep 14;12:20406223211046076. PMID: 34729146
PMC - PMC8323410
OTO - NOTNLM
OT  - effectiveness
OT  - mitoxantrone
OT  - multiple sclerosis
OT  - rituximab
OT  - safety
COIS- Conflict of interest statement: Tobias Zrzavy has participated in meetings 
      sponsored by or received travel funding from Biogen, Merck, Novartis, Roche, 
      Sanofi-Genzyme and Teva. Esther Daniels declares no conflict of interest. 
      Alexander Winkelmann participated in meetings sponsored by, received speaker 
      honoraria or travel funding from Celgene, Merck, Novartis, Sanofi-Genzyme and 
      Teva, and received honoraria for consulting Merck, Novartis, Roche, 
      Sanofi-Genzyme and Teva. Helmut Rauschka has participated in meetings sponsored 
      by or received travel funding from Alexion, Biogen, Merck, Novartis, Pfizer, 
      Sanofi-Genzyme and Teva. Michael Hecker received speaking fees and travel funds 
      from Bayer HealthCare, Biogen, Merck, Novartis and Teva. Dennis Weber declares no 
      conflict of interest. Niklas Stuka declares no conflict of interest. Fahmy 
      Aboulenein-Djamshidian declares no conflict of interest. Stefanie Meister 
      declares no conflict of interest relevant to this study. Fritz Leutmezer has 
      received honoraria for consultancy/speaking from Allmiral, Alexion, Biogen, 
      MedDay, Merck, Novartis, Octapharma, Roche, Sanofi-Genzyme, and Teva. Thomas 
      Berger has participated in meetings sponsored by and received honoraria 
      (lectures, advisory boards, consultations) from pharmaceutical companies 
      marketing treatments for MS: Allergan, Bayer, Biogen, Bionorica, Celgene, MedDay, 
      Merck, Novartis, Octapharma, Roche, Sanofi-Genzyme, Teva. His institution has 
      received financial support in the past 12 months by unrestricted research grants 
      (Biogen, Bayer, Merck, Novartis, Sanofi Aventis, Teva) and for participation in 
      clinical trials in multiple sclerosis sponsored by Alexion, Bayer, Biogen, Merck, 
      Novartis, Octapharma, Roche, Sanofi-Genzyme, Teva. Gabriel Bsteh has participated 
      in meetings sponsored by, received speaker honoraria or travel funding from 
      Biogen, Celgene, Lilly, Merck, Novartis, Sanofi-Genzyme and Teva, and received 
      honoraria for consulting Biogen, Celgene, Merck, Novartis, Roche and Teva. Uwe 
      Klaus Zettl received research support as well as speaking fees and travel funds 
      from Almirall, Bayer HealthCare, Biogen, Merck Serono, Novartis, Sanofi-Genzyme 
      and Teva. Paulus Rommer has received honoraria for consultancy/speaking from 
      AbbVie, Allmiral, Alexion, Biogen, Merck, Novartis, Roche, Sandoz, 
      Sanofi-Genzyme, has received research grants from Amicus, Biogen, Merck, Roche.
EDAT- 2021/08/12 06:00
MHDA- 2021/08/12 06:01
PMCR- 2021/07/28
CRDT- 2021/08/11 06:38
PHST- 2021/02/23 00:00 [received]
PHST- 2021/05/12 00:00 [accepted]
PHST- 2021/08/11 06:38 [entrez]
PHST- 2021/08/12 06:00 [pubmed]
PHST- 2021/08/12 06:01 [medline]
PHST- 2021/07/28 00:00 [pmc-release]
AID - 10.1177_20406223211024366 [pii]
AID - 10.1177/20406223211024366 [doi]
PST - epublish
SO  - Ther Adv Chronic Dis. 2021 Jul 28;12:20406223211024366. doi: 
      10.1177/20406223211024366. eCollection 2021.