PMID- 37166677 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20231119 IS - 2193-8253 (Print) IS - 2193-6536 (Electronic) IS - 2193-6536 (Linking) VI - 12 IP - 4 DP - 2023 Aug TI - Tailoring Rituximab According to CD27-Positive B-Cell versus CD19-Positive B-Cell Monitoring in Neuromyelitis Optica Spectrum Disorder and MOG-Associated Disease: Results from a Single-Center Study. PG - 1375-1383 LID - 10.1007/s40120-023-00481-w [doi] AB - INTRODUCTION: B-cell-depleting agents have been widely used for neuromyelitis optica spectrum disorder (NMOSD) and MOG-associated diseases (MOGAD), but no consensus exists on the optimal dose and frequency of treatment administration. The aim of our study was to evaluate the effect of a Rituximab (RTX) personalized treatment approach based on CD27-positive B-cell monitoring on efficacy, safety, and infusion rates. METHODS: This is a retrospective, uncontrolled, single-center study including patients with NMOSD and MOGAD treated with RTX at a tertiary multiple sclerosis center at the San Luigi University Hospital, Orbassano, Italy. All the patients were treated with RTX induction, followed by maintenance infusion at the dosage of 1000 mg according to cell repopulation: initially according to total CD19-positive B-cell monitoring (> 0.1% of lymphocytes), and subsequently according to CD27-positive B-cell repopulation (> 0.05% of lymphocytes for the first 2 years, and subsequently > 0.1%). NMOSD and MOGAD activity was assessed as clinical or MRI activity. All patients were screened of the occurrence of severe adverse events (AEs). RESULTS: A total of 19 patients were included in the analysis. Median follow-up was 7.64 years (range 3.09-16.25). The annualized relapse rate (ARR) 1 year before RTX start was 2.37 [Standard deviation (SD), 1.34] and decreased to 0.08 (SD 0.11) in the subsequent years after RTX initiation. ARR did not differ before and after start of CD27 monitoring. Median inter-dose time was 8.80 (range 5.78-14.23) before CD27 monitoring and 15.93 months (range 8.56-35.37) after CD27 monitoring (p < 0.001). We observed no AEs. CONCLUSION: Our findings suggest that in our cohort CD27-positive B-cell-based RTX reinfusion regimen was able to reduce the number of RTX reinfusions relative to CD19-positive B-cell monitoring, with comparable efficacy and safety profile. In order to achieve an even more individualized and effective treatment, the FCGR3A genetic polymorphisms could be evaluated when assessing RTX efficacy. CI - (c) 2023. The Author(s). FAU - Bruschi, Nicolo AU - Bruschi N AD - Radiology Unit, Department of Surgical Sciences, University of Turin, Azienda Ospedaliero Universitaria (A.O.U.) Citta della Salute e della Scienza di Torino, Turin, Italy. AD - Regional Referring Center for Multiple Sclerosis (CRESM), University Hospital San Luigi Gonzaga, Orbassano, Italy. FAU - Malentacchi, Maria AU - Malentacchi M AD - Regional Referring Center for Multiple Sclerosis (CRESM), University Hospital San Luigi Gonzaga, Orbassano, Italy. FAU - Malucchi, Simona AU - Malucchi S AD - Regional Referring Center for Multiple Sclerosis (CRESM), University Hospital San Luigi Gonzaga, Orbassano, Italy. FAU - Sperli, Francesca AU - Sperli F AD - Regional Referring Center for Multiple Sclerosis (CRESM), University Hospital San Luigi Gonzaga, Orbassano, Italy. FAU - Martire, Serena AU - Martire S AD - Clinical Neurobiology Unit, Neuroscience Institute Cavalieri Ottolenghi (NICO), University Hospital San Luigi Gonzaga, Orbassano, Turin, Italy. FAU - Sala, Arianna AU - Sala A AD - Clinical Neurobiology Unit, University Hospital San Luigi Gonzaga, Orbassano, Turin, Italy. FAU - Valentino, Paola AU - Valentino P AD - Clinical Neurobiology Unit, Neuroscience Institute Cavalieri Ottolenghi (NICO), University Hospital San Luigi Gonzaga, Orbassano, Turin, Italy. FAU - Bertolotto, Antonio AU - Bertolotto A AD - Ospedale Koelliker, Corso Galileo Ferraris 247, Turin, Italy. FAU - Pautasso, Marisa AU - Pautasso M AD - Laboratory of Clinical and Microbiological Analyses, University Hospital San Luigi Gonzaga, Orbassano, Turin, Italy. FAU - Capobianco, Marco Alfonso AU - Capobianco MA AUID- ORCID: 0000-0003-2501-2932 AD - Department of Neurology, "S. Croce e Carle" Hospital, Cuneo, Italy. mcapobianco1972@gmail.com. AD - , Via Coppino 26, Cuneo, Italy. mcapobianco1972@gmail.com. LA - eng PT - Journal Article DEP - 20230511 PL - New Zealand TA - Neurol Ther JT - Neurology and therapy JID - 101637818 PMC - PMC10310632 OTO - NOTNLM OT - CD27-positive B-cell OT - MOG-associated diseases OT - Neuromyelitis optica spectrum disorder OT - Rituximab COIS- Dr. Nicolo Bruschi has nothing to disclose. Dr. Maria Malentacchi received fees from Novartis and Biogen Idec for speaking in scientific meetings. Dr. Simona Malucchi received fees from Merck Serono, Biogen Idec, Novartis and Bristol Meyers for participation in advisory boards and for speaking in scientific meetings. Dr. Francesca Sperli received fees from Merck Serono, Biogen Idec, Novartis and Sanofi for participation in advisory boards and for speaking in scientific meetings. Dr. Arianna Sala has nothing to disclose. Dr. Paola Valentino received speaker honoraria from Roche, Biogen and Novartis,research support from Merck and grant support from Quanterix. Dr. Serena Martire has nothing to disclose. Dr. Antonio Bertolotto received honoraria for contribution in research, consultancy activity and activity of lectures from Almirall, Bayer, Biogen, Genzyme, Merck, Sanofi, Novartis, FISM, TEVA. Dr. Marisa Pautasso has nothing to disclose. Dr. Marco Alfonso Capobianco served on advisory board for Merck Serono, Biogen, Sanofi Genzyme, Roche, Novartis. Received honoraria from Almirall, Biogen, Novartis, Merck Serono, TEVA, Sanofi Genzyme. EDAT- 2023/05/11 13:18 MHDA- 2023/05/11 13:19 PMCR- 2023/05/11 CRDT- 2023/05/11 11:13 PHST- 2022/05/02 00:00 [received] PHST- 2023/04/12 00:00 [accepted] PHST- 2023/05/11 13:19 [medline] PHST- 2023/05/11 13:18 [pubmed] PHST- 2023/05/11 11:13 [entrez] PHST- 2023/05/11 00:00 [pmc-release] AID - 10.1007/s40120-023-00481-w [pii] AID - 481 [pii] AID - 10.1007/s40120-023-00481-w [doi] PST - ppublish SO - Neurol Ther. 2023 Aug;12(4):1375-1383. doi: 10.1007/s40120-023-00481-w. Epub 2023 May 11.