Lin Jie, Xue Binbin, Li Jia, Zhu Ruofan, Pan Juyuan, Chen Zhibo, Zhang Xu, Li Xiang, Xia Junhui
Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Department of Anesthesiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Front Neurol. 2022 May 6;13:891064. doi: 10.3389/fneur.2022.891064. eCollection 2022.
Several studies have reported the efficacy and safety of rituximab (RTX) and mycophenolate mofetil (MMF) in neuromyelitis optica spectrum disorder (NMOSD). This study aimed to evaluate the efficacy and safety of long-term use of low-dose RTX and MMF in Chinese patients with NMOSD.
We retrospectively reviewed data from patients with NMOSD in our hospital. The enrolled patients were administrated different immunosuppressive agents. We accessed annual relapse rate (ARR), neurological disability (Expanded Disability Status Scale, EDSS), time to the next relapse, and adverse events.
EDSS and ARR were both reduced after RTX and MMF treatment. Kaplan-Meier analysis indicated that patients treated with RTX had a longer time to next relapse compared other immunosuppressive agents before RTX (log-rank test: < 0.001). Furthermore, we evaluated the change of EDSS and ARR in RTX and MMF, and patients treated with RTX showed a better reduction. Eleven relapses from seven patients in group RTX and 20 relapses from 14 patients in group MMF were reported during follow-up.
Long-term using of low dose of RTX and MMF were effective and tolerable in Chinese patients with NMOSD. Compared with MMF, RTX showed a better way to reduce the ARR.
多项研究报道了利妥昔单抗（RTX）和霉酚酸酯（MMF）治疗视神经脊髓炎谱系障碍（NMOSD）的疗效和安全性。本研究旨在评估长期使用低剂量RTX和MMF对中国NMOSD患者的疗效和安全性。
我们回顾性分析了我院NMOSD患者的数据。纳入的患者接受了不同的免疫抑制剂治疗。我们评估了年复发率（ARR）、神经功能障碍（扩展残疾状态量表，EDSS）、下次复发时间和不良事件。
RTX和MMF治疗后EDSS和ARR均降低。Kaplan-Meier分析表明，与RTX治疗前的其他免疫抑制剂相比，接受RTX治疗的患者下次复发时间更长（对数秩检验：<0.001）。此外，我们评估了RTX和MMF治疗后EDSS和ARR的变化，接受RTX治疗的患者下降更明显。随访期间，RTX组7例患者出现11次复发，MMF组14例患者出现20次复发。
长期使用低剂量RTX和MMF对中国NMOSD患者有效且耐受性良好。与MMF相比，RTX在降低ARR方面效果更佳。
