Neuromuscular Centre, Department of Neurology, Sahlgrenska University Hospital, Göteborg, Sweden.
Acta Neurol Scand. 2010 Oct;122(4):225-8. doi: 10.1111/j.1600-0404.2010.01345.x.
Rituximab (RTX), a monoclonal antibody directed against CD20+ B cells, is used in the treatment of several autoimmune disorders including severe generalized myasthenia gravis (MG).
To describe the experience with RTX in five MG patients treated at our Neuromuscular Centre.
Effect of RTX treatment was monitored by quantitative MG score (QMG score), forced vital capacity (FVC) and records of clinical parameters. Three patients had thymoma. Duration of MG prior to the first course of RTX was 3, 7, 26, 26 and 38 years.
We found favourable response to RTX treatment in all five patients. QMG score was markedly lower after RTX and in the three patients with respiratory muscle affection the FVC was increased. A good relief of bulbar, respiratory or extremity MG weakness was thus also found in the three patients who had long-standing severe MG. Repeated RTX treatment was needed in four patients.
We conclude that RTX is effective in recent onset MG as well as in long-standing cases. As thymoma is prevalent in patients with severe MG, further studies are needed to evaluate the risk of thymoma recurrence following RTX treatment.
利妥昔单抗（RTX）是一种针对 CD20+B 细胞的单克隆抗体，用于治疗多种自身免疫性疾病，包括严重全身性重症肌无力（MG）。
描述在我们的神经肌肉中心治疗的五例 MG 患者使用 RTX 的经验。
通过定量 MG 评分（QMG 评分）、用力肺活量（FVC）和临床参数记录监测 RTX 治疗的效果。三名患者患有胸腺瘤。五名患者中，首剂 RTX 治疗前 MG 的持续时间分别为 3、7、26、26 和 38 年。
我们发现所有五例患者对 RTX 治疗均有良好反应。RTX 后 QMG 评分明显降低，在呼吸肌无力的三名患者中 FVC 增加。因此，在三名患有长期严重 MG 的患者中，还发现了球部、呼吸或四肢 MG 无力的明显缓解。四名患者需要重复 RTX 治疗。
我们得出结论，RTX 对新发 MG 和长期病例均有效。由于胸腺瘤在重症 MG 患者中较为常见，需要进一步研究评估 RTX 治疗后胸腺瘤复发的风险。
