Iorio Raffaele, Damato Valentina, Alboini Paolo Emilio, Evoli Amelia
Don Carlo Gnocchi ONLUS Foundation, Milan, Italy,
J Neurol. 2015 May;262(5):1115-9. doi: 10.1007/s00415-014-7532-3. Epub 2014 Oct 12.
Myasthenia gravis is an autoimmune disorder of the neuromuscular junction caused by circulating antibodies specific for the post-synaptic acetylcholine receptor or, in a minority of cases, for the muscle-specific tyrosine-kinase and the low-density lipoprotein receptor-related protein 4. A wide range of symptomatic and immunosuppressive treatments is currently available for MG patients with variable outcome. However, most immunosuppressive treatments are characterized by delayed onset of action and in some cases are not sufficient to induce stable remission of the disease. Rituximab (RTX) is a chimaeric monoclonal antibody specific for the CD20 B-cell surface antigen. Recent studies have provided evidence that RTX may be an effective treatment for patients with myasthenia gravis (MG) who are refractory to standardized immunosuppressive therapy. We performed a systematic review and a meta-analysis of the efficacy and safety of RTX in myasthenia gravis considering the potential predictive factors related to patients' response to RTX in this disease.
重症肌无力是一种神经肌肉接头处的自身免疫性疾病，由针对突触后乙酰胆碱受体的循环抗体引起，少数情况下由针对肌肉特异性酪氨酸激酶和低密度脂蛋白受体相关蛋白4的抗体引起。目前有多种对症和免疫抑制治疗方法可供重症肌无力患者使用，疗效各异。然而，大多数免疫抑制治疗的特点是起效延迟，在某些情况下不足以诱导疾病稳定缓解。利妥昔单抗（RTX）是一种针对CD20 B细胞表面抗原的嵌合单克隆抗体。最近的研究表明，RTX可能是对标准化免疫抑制治疗无效的重症肌无力（MG）患者的有效治疗方法。我们对RTX治疗重症肌无力的疗效和安全性进行了系统评价和荟萃分析，同时考虑了与该疾病患者对RTX反应相关的潜在预测因素。
