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利妥昔单抗的安全性与有效性:单一多发性硬化症中心的经验

Safety and Efficacy of Rituximab: Experience of a Single Multiple Sclerosis Center.

作者信息

Alldredge Brett, Jordan Allison, Imitola Jaime, Racke Michael K

机构信息

The Ohio State University Wexner Medical Center, Columbus, OH.

出版信息

Clin Neuropharmacol. 2018 Mar/Apr;41(2):56-59. doi: 10.1097/WNF.0000000000000268.

Abstract

OBJECTIVES

Multiple sclerosis (MS) is an immune-mediated disease of the central nervous system. B cells play an important pathogenic role in MS. Rituximab (RTX), a B-cell depleting drug, has been used to treat MS and neuromyelitis optica (NMO). Patient characteristics, safety, and efficacy measures are reviewed to ascertain the therapeutic benefit and safety of RTX in a real-world setting with long-term follow-up.

METHODS

This is a retrospective chart review of patients who received RTX at The Ohio State University's MS clinic from January 2005 to October 2016.

RESULTS

Of the 64 patient charts reviewed, 23 had a relapsing remitting MS, 17 had primary progressive MS (PPMS), and 24 had NMO. In the relapsing remitting MS cohort, there was an annual relapse rate of 0.005 and 87% were reported as clinically stable at the end of the chart review period. In the primary progressive MS cohort, 47% were reported as clinically stable at the end of the chart review period. In the NMO cohort, there was an annual relapse rate of 0.0074 and 79% were reported as clinically stable at the end of the chart review period. A total of 29 infusion reactions were reported in 21 patients. None were serious and only 1 patient elected to stop RTX due to an adverse event.

CONCLUSIONS

Rituximab demonstrated good tolerability and efficacy in cases of both relapsing and progressive forms of MS and NMO.

摘要

目的

多发性硬化症(MS)是一种中枢神经系统的免疫介导疾病。B细胞在MS中发挥重要的致病作用。利妥昔单抗(RTX)是一种耗竭B细胞的药物,已被用于治疗MS和视神经脊髓炎(NMO)。回顾患者特征、安全性和疗效指标,以确定在长期随访的真实世界环境中RTX的治疗益处和安全性。

方法

这是一项对2005年1月至2016年10月在俄亥俄州立大学MS诊所接受RTX治疗的患者进行的回顾性病历审查。

结果

在审查的64份患者病历中,23例为复发缓解型MS,17例为原发进展型MS(PPMS),24例为NMO。在复发缓解型MS队列中,年复发率为0.005,在病历审查期结束时,87%的患者报告临床稳定。在原发进展型MS队列中,在病历审查期结束时,47%的患者报告临床稳定。在NMO队列中,年复发率为0.0074,在病历审查期结束时,79%的患者报告临床稳定。共21例患者报告了29次输液反应。均不严重,只有1例患者因不良事件选择停止使用RTX。

结论

利妥昔单抗在复发型和进展型MS及NMO病例中均显示出良好的耐受性和疗效。

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