Response of patients with refractory myasthenia gravis to rituximab: a retrospective study
- 4 July 2011
- journal article
- Published by SAGE Publications in Therapeutic Advances in Neurological Disorders
- Vol. 4 (5), 259-266
- https://doi.org/10.1177/1756285611411503
Abstract
Myasthenia gravis, an autoimmune disorder of neuromuscular transmission, is treated by an array of immunomodulating therapies. A variable response is observed with certain patients being medically refractory. We report the results of 14 refractory generalized myasthenia gravis patients (6 AChR+; 8 MuSK+) treated with rituximab. Sustained clinical improvement was observed in all patients as well as a reduction of conventional immunotherapies. Prednisone dose decreased a mean of 65.1%, 85.7%, and 93.8% after cycle 1, 2, and 3 of rituximab therapy, respectively. A statistically significant reduction in plasma exchange sessions was seen after cycle 1 with all patients being off of plasma exchange after cycle 3. Acetylcholine receptor antibody titers decreased a mean of 52.1% (p = 0.0046) post-cycle 2. Our results support the hypothesis that rituximab is beneficial and well tolerated in managing refractory myasthenia gravis and nearly doubles published cases. We propose that B-cell-directed therapies may become an attractive option and suggest pursuit of a prospective trial.Keywords
This publication has 24 references indexed in Scilit:
- CD20‐depleting therapy in autoimmune diseases: from basic research to the clinicJournal of Internal Medicine, 2010
- Rituximab in the management of refractory myasthenia gravisMuscle & Nerve, 2009
- Rituximab for myasthenia gravis: Three case reports and review of the literatureJournal of the Neurological Sciences, 2009
- [Loss of CD20 expression following rituximab-combined chemotherapy in CD20-positive and CyclinD1-positive multiple myeloma].2008
- Invited Article: Inhibition of B cell functionsNeurology, 2008
- Steroids and immunosuppressant drugs in myasthenia gravisNature Clinical Practice Neurology, 2008
- Complete remission induced by rituximab in refractory, seronegative, muscle-specific, kinase-positive myasthenia gravisJournal of Neurology, Neurosurgery & Psychiatry, 2006
- Response of myasthenia gravis to rituximab in a patient with non‐Hodgkin lymphomaAmerican Journal of Hematology, 2004
- Efficacy of B-Cell–Targeted Therapy with Rituximab in Patients with Rheumatoid ArthritisThe New England Journal of Medicine, 2004
- An overview of the current clinical use of the anti-CD20 monoclonal antibody rituximabAnnals of Oncology, 2003