Patil Varsha A, Kamat Saurabh N, Lalkaka Jamshed A, Singhal Bhim
Department of Neurology, Bombay Hospital and Medical Research Centre, New Marine Lines, Mumbai, Maharashtra, India.
Ann Indian Acad Neurol. 2021 Sep-Oct;24(5):732-739. doi: 10.4103/aian.AIAN_167_21. Epub 2021 Jun 22.
Rituximab, an anti-CD20 monoclonal antibody, has been used worldwide as an off-label therapy in patients with multiple sclerosis (MS) and neuromyelitis optica spectrum disorders (NMOSD).
The aim of the present study was to evaluate the efficacy and safety of rituximab in central nervous system demyelinating disorders in the Indian context.
We conducted a retrospective analysis of patients with MS, NMOSD, and myelin oligodendrocyte glycoprotein antibody disease (MOGAD) who were treated with rituximab at a single tertiary care centre in Mumbai.
The study enrolled 102 patients (61 MS, 37 NMOSD and 4 MOGAD) from June 2008 to January 2020. Following rituximab therapy, 96.7% of MS, 67% of NMOSD, and 50% of MOGAD patients were free of relapses. The mean annualized relapse rate reduced from 2.17 to 0 for patients with relapsing remitting MS (RRMS), from 0.8 to 0 for secondary progressive MS (SPMS), from 2.5 to 0.14 for NMOSD, and from 3.43 to 1.04 for MOGAD. The median expanded disability status scale improved significantly in RRMS patients, worsened non-significantly in the SPMS group, and remained unchanged in NMOSD and MOGAD patients. On follow-up magnetic resonance imaging, there was a significant reduction in the number of MS patients developing new contrast enhancing lesions or new T2 lesions. Adverse events (infusion reactions or severe infections) occurred in 12 patients.
Rituximab is effective and safe in Indian patients with MS and NMOSD.
利妥昔单抗是一种抗CD20单克隆抗体，在全球范围内已被超说明书用于治疗多发性硬化症（MS）和视神经脊髓炎谱系障碍（NMOSD）患者。
本研究的目的是评估在印度背景下利妥昔单抗治疗中枢神经系统脱髓鞘疾病的疗效和安全性。
我们对在孟买一家三级医疗中心接受利妥昔单抗治疗的MS、NMOSD和髓鞘少突胶质细胞糖蛋白抗体病（MOGAD）患者进行了回顾性分析。
该研究纳入了2008年6月至2020年1月期间的102例患者（61例MS、37例NMOSD和4例MOGAD）。利妥昔单抗治疗后，96.7%的MS患者、67%的NMOSD患者和50%的MOGAD患者无复发。复发缓解型MS（RRMS）患者的年均复发率从2.17降至0，继发进展型MS（SPMS）患者从0.8降至0，NMOSD患者从2.5降至0.14，MOGAD患者从3.43降至1.04。RRMS患者的扩展残疾状态量表中位数显著改善，SPMS组非显著恶化，NMOSD和MOGAD患者保持不变。在随访磁共振成像中，出现新的强化病灶或新的T2病灶的MS患者数量显著减少。12例患者发生不良事件（输液反应或严重感染）。
利妥昔单抗在印度MS和NMOSD患者中有效且安全。
