Whittam DH
Cobo-Calvo A
Lopez-Chiriboga AS
Pardo S
Gornall M
Cicconi S
Brandt A
Berek K
Berger T
Jelcic I
Gombolay G
Oliveira LM
Callegaro D
Kaneko K
Misu T
Capobianco M
Gibbons E
Karthikeayan V
Brochet B
Audoin B
Mathey G
Laplaud D
Thouvenot E
Cohen M
Tourbah A
Maillart E
Ciron J
Deschamps R
Biotti D
Rostasy K
Neuteboom R
Hemingway C
Forsyth R
Matiello M
Webb S
Hunt D
Murray K
Hacohen Y
Lim M
Leite MI
Palace J
Solomon T
Lutterotti A
Fujihara K
Nakashima I
Bennett JL
Pandit L
Chitnis T
Weinshenker BG
Wildemann B
Sato DK
Kim SH
Huda S
Kim HJ
Reindl M
Levy M
Jarius S
Tenembaum S
Paul F
Pittock S
Marignier R
Jacob A
2020
OBJECTIVE
To assess the effect of anti-CD20 B-cell depletion with rituximab (RTX) on relapse rates in myelin oligodendrocyte glycoprotein antibody-associated disorder (MOGAD).
METHODS
Retrospective review of RTX-treated MOGAD patients from 29 centres in 13 countries. The primary outcome measure was change in relapse rate after starting rituximab (Poisson regression model).
RESULTS
Data on 121 patients were analysed, including 30 (24.8%) children. Twenty/121 (16.5%) were treated after one attack, of whom 14/20 (70.0%) remained relapse-free after median (IQR) 11.2 (6.3-14.1) months. The remainder (101/121, 83.5%) were treated after two or more attacks, of whom 53/101 (52.5%) remained relapse-free after median 12.1 (6.3-24.9) months. In this 'relapsing group', relapse rate declined by 37% (95%CI=19-52%, p<0.001) overall, 63% (95%CI=35-79%, p = 0.001) when RTX was used first line (n = 47), and 26% (95%CI=2-44%, p = 0.038) when used after other steroid-sparing immunotherapies (n = 54). Predicted 1-year and 2-year relapse-free survival was 79% and 55% for first-line RTX therapy, and 38% and 18% for second-/third-line therapy. Circulating CD19+B-cells were suppressed to <1% of total circulating lymphocyte population at the time of 45/57 (78.9%) relapses.
CONCLUSION
RTX reduced relapse rates in MOGAD. However, many patients continued to relapse despite apparent B-cell depletion. Prospective controlled studies are needed to validate these results.
https://sonar.ch/global/documents/95315
eng
info:eu-repo/semantics/altIdentifier/doi/10.1016/j.msard.2020.102251
info:eu-repo/semantics/altIdentifier/pmid/32629363
Multiple sclerosis and related disorders. - 2020
MOG
Myelin oligodendrocyte glycoprotein
Neuromyelitis optica
Optic neuritis
Rituximab
Treatment of MOG-IgG-associated disorder with rituximab: An international study of 121 patients.
http://purl.org/coar/resource_type/c_6501