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在肌肉特异性酪氨酸激酶抗体阳性重症肌无力中使用利妥昔单抗:来自印度北部一家三级保健中心的初步观察结果。

Use of rituximab in muscle-specific tyrosine kinase antibody-positive myasthenia gravis: Preliminary observations from a tertiary care center in Northern India.

机构信息

Department of Neurology, Postgraduate Institute of Medical and Research, Chandigarh, India.

出版信息

Indian J Pharmacol. 2020 Jan-Feb;52(1):49-52. doi: 10.4103/ijp.IJP_333_18. Epub 2020 Mar 11.

DOI:10.4103/ijp.IJP_333_18
PMID:32201447
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7074426/
Abstract

OBJECTIVES

Approximately 10%-15% of patients with myasthenia gravis (MG) are refractory to standard treatment. A sizable chunk of these patients is due to muscle-specific tyrosine kinase (MuSK) antibody-positive MG which often runs a severe course with frequent relapses and poor response to conventional treatment. We report six patients with refractory MuSK-positive MG who responded well to the treatment with rituximab.

PATIENTS AND METHODS

In this prospective institute-based observational study, we report six MuSK antibody-positive MG patients, who did not achieve remission with standard treatment and were later started on rituximab infusion.

RESULTS

There was a significant clinical improvement in all patients after starting rituximab.

CONCLUSION

Rituximab is an effective immunomodulatory therapy in MuSK antibody-positive MG patients who are not responding to the standard treatment.

摘要

目的

约 10%-15%的重症肌无力 (MG) 患者对标准治疗无反应。这些患者中有相当一部分是由于肌肉特异性酪氨酸激酶 (MuSK) 抗体阳性 MG 引起的,这种疾病通常病情严重,频繁复发,对常规治疗反应不佳。我们报告了 6 例对标准治疗无反应的 MuSK 阳性 MG 患者,他们对利妥昔单抗治疗反应良好。

患者和方法

在这项前瞻性的基于机构的观察性研究中,我们报告了 6 例 MuSK 抗体阳性 MG 患者,他们在标准治疗后未达到缓解,并随后开始利妥昔单抗输注。

结果

所有患者在开始利妥昔单抗治疗后均有显著的临床改善。

结论

利妥昔单抗是 MuSK 抗体阳性 MG 患者的一种有效免疫调节治疗方法,这些患者对标准治疗无反应。

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本文引用的文献

1
Rituximab treatment of myasthenia gravis: A systematic review.利妥昔单抗治疗重症肌无力:一项系统评价。
Muscle Nerve. 2017 Aug;56(2):185-196. doi: 10.1002/mus.25597. Epub 2017 Mar 21.
2
Resistant myasthenia gravis and rituximab: A monocentric retrospective study of 28 patients.难治性重症肌无力与利妥昔单抗:一项针对28例患者的单中心回顾性研究。
Neuromuscul Disord. 2017 Mar;27(3):251-258. doi: 10.1016/j.nmd.2016.12.004. Epub 2016 Dec 14.
3
Rituximab in refractory myasthenia gravis: a prospective, open-label study with long-term follow-up.利妥昔单抗治疗难治性重症肌无力:一项前瞻性、开放标签研究及长期随访。
Ann Clin Transl Neurol. 2016 May 25;3(7):552-5. doi: 10.1002/acn3.314. eCollection 2016 Jul.
4
Muscle autoantibodies in myasthenia gravis: beyond diagnosis?重症肌无力中的肌肉自身抗体:超越诊断?
Expert Rev Clin Immunol. 2012 Jul;8(5):427-38. doi: 10.1586/eci.12.34.
5
Long-lasting treatment effect of rituximab in MuSK myasthenia.利妥昔单抗治疗 MuSK 肌无力的持久疗效。
Neurology. 2012 Jan 17;78(3):189-93. doi: 10.1212/WNL.0b013e3182407982. Epub 2012 Jan 4.
6
Response of patients with refractory myasthenia gravis to rituximab: a retrospective study.难治性重症肌无力患者对利妥昔单抗的反应:一项回顾性研究。
Ther Adv Neurol Disord. 2011 Sep;4(5):259-66. doi: 10.1177/1756285611411503.
7
Rituximab in the management of refractory myasthenia gravis.利妥昔单抗治疗难治性重症肌无力。
Muscle Nerve. 2010 Mar;41(3):375-8. doi: 10.1002/mus.21521.
8
Successful treatment of refractory generalized myasthenia gravis with rituximab.利妥昔单抗成功治疗难治性全身型重症肌无力。
Eur J Neurol. 2009 Feb;16(2):246-50. doi: 10.1111/j.1468-1331.2008.02399.x.
9
Rituximab, an anti-cd20 monoclonal antibody: history and mechanism of action.利妥昔单抗,一种抗CD20单克隆抗体:历史与作用机制
Am J Transplant. 2006 May;6(5 Pt 1):859-66. doi: 10.1111/j.1600-6143.2006.01288.x.
10
Successful treatment of MuSK antibody-positive myasthenia gravis with rituximab.利妥昔单抗成功治疗MuSK抗体阳性重症肌无力。
Muscle Nerve. 2006 Apr;33(4):575-80. doi: 10.1002/mus.20479.