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Treatment of MOG-IgG-associated disorder with rituximab: An international study of 121 patients.
Journal article

Treatment of MOG-IgG-associated disorder with rituximab: An international study of 121 patients.

  • Whittam DH Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom; Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom. Electronic address: daniel.whittam@nhs.net.
  • Cobo-Calvo A Pathologies de la Myéline et Neuro-inflammation, Hôpital Neurologique Pierre Wertheimer Hospices Civils de Lyon, Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle, INSERM U1028, CNRS UMR 5292, Lyon 1 University, Center for Research in Neuroscience of Lyon, Lyon, France.
  • Lopez-Chiriboga AS Department of Neurology, Mayo Clinic, Rochester, Minnesota, United States.
  • Pardo S Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States.
  • Gornall M Liverpool Clinical Trials Centre, University of Liverpool, Liverpool, United Kingdom.
  • Cicconi S Liverpool Clinical Trials Centre, University of Liverpool, Liverpool, United Kingdom.
  • Brandt A Experimental and Clinical Research Center Max Delbrueck Center for Molecular Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany.
  • Berek K Medical University of Innsbruck, Innsbruck, Austria.
  • Berger T Department of Neurology, Medical University of Vienna, Vienna, Austria.
  • Jelcic I UniversitätsSpital Zürich, Zürich, Switzerland.
  • Gombolay G Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States; Emory & Children's Pediatric Institute, Atlanta, Georgia, United States.
  • Oliveira LM Hospital das Clinicas Faculty of Medicine, University of São Paulo, São Paulo, Brazil.
  • Callegaro D Hospital das Clinicas Faculty of Medicine, University of São Paulo, São Paulo, Brazil.
  • Kaneko K Tohoku University Graduate School of Medicine, Sendai, Japan.
  • Misu T Tohoku University Graduate School of Medicine, Sendai, Japan.
  • Capobianco M Neurology Dept. - Regional MS Centre, S. Luigi University Hospital, Orbassano, Italy.
  • Gibbons E Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom; Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom.
  • Karthikeayan V Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom.
  • Brochet B CHU de Bordeaux & INSERM U 1215, University of Bordeaux, Bordeaux, France.
  • Audoin B Aix Marseille University, APHM, Hôpital de La Timone, Marseille, France.
  • Mathey G Nancy University Hospital and Inserm CIC 1433, Nancy, France.
  • Laplaud D Nantes University Hospital, Nantes, France.
  • Thouvenot E Hôpital Carémeau, Nimes University Hospital, Nimes, France.
  • Cohen M Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Nice, France.
  • Tourbah A Reims University Hospital, University of Reims Champagne-Ardenne, Reims, LPN EA 2027, University of Paris VIII, Saint-Denis, France.
  • Maillart E Pitié-Salpêtrière Hospital, APHP, Paris, France.
  • Ciron J Poitiers University Hospital, Poitiers, France.
  • Deschamps R Fondation A. De Rothschild, Paris, France.
  • Biotti D University Hospital of Purpan, Toulouse, France.
  • Rostasy K Department of Pediatric Neurology, Children's Hospital Datteln, University Witten/Herdecke, Witten, Germany.
  • Neuteboom R Department of Paediatric Neurology, Erasmus MC-Sophia, Rotterdam, the Netherlands; Department of Neurology, MS Centre ErasMS, Erasmus MC, Rotterdam, the Netherlands.
  • Hemingway C Department of Paediatric Neurology, Great Ormond Street Hospital for Children, London, United Kingdom.
  • Forsyth R Institute of Neuroscience, Newcastle University, Newcastle, United Kingdom.
  • Matiello M Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States.
  • Webb S Department of Neurology, Queen Elizabeth University Hospital, Glasgow, United Kingdom.
  • Hunt D Anne Rowling Regenerative Neurology Clinic, University of Edinburgh, Edinburgh, United Kingdom.
  • Murray K Anne Rowling Regenerative Neurology Clinic, University of Edinburgh, Edinburgh, United Kingdom.
  • Hacohen Y Department of Paediatric Neurology, Great Ormond Street Hospital for Children, London, United Kingdom; Department of Neuroinflammation, Queen Square MS Centre, UCL Institute of Neurology, London, United Kingdom.
  • Lim M Children's Neuroscience, Evelina London Children's Hospital @ Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom; Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom.
  • Leite MI Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, United Kingdom.
  • Palace J Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, United Kingdom.
  • Solomon T Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom; Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom.
  • Lutterotti A UniversitätsSpital Zürich, Zürich, Switzerland.
  • Fujihara K Tohoku University Graduate School of Medicine, Sendai, Japan.
  • Nakashima I Department of Neurology, Tohoku Medical and Pharmaceutical University, Sendai, Japan.
  • Bennett JL Departments of Neurology and Ophthalmology, Program in Neuroscience, University of Colorado School of Medicine, Aurora, Colorado, United States.
  • Pandit L Nitte University, Mangaluru, Karnataka, India.
  • Chitnis T Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States.
  • Weinshenker BG Department of Neurology, Mayo Clinic, Rochester, Minnesota, United States.
  • Wildemann B Molecular Neuroimmunology Group, Department of Neurology, University of Heidelberg, Heidelberg, Germany.
  • Sato DK Hospital das Clinicas Faculty of Medicine, University of São Paulo, São Paulo, Brazil; Tohoku University Graduate School of Medicine, Sendai, Japan; Pontificia Universidade Catolica Rio Grande Do Sul, Porto Alegre RS, Brazil.
  • Kim SH Research Institute and Hospital of National Cancer Center, Goyang, South Korea.
  • Huda S Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom; Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom.
  • Kim HJ Research Institute and Hospital of National Cancer Center, Goyang, South Korea.
  • Reindl M Medical University of Innsbruck, Innsbruck, Austria.
  • Levy M Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States.
  • Jarius S Molecular Neuroimmunology Group, Department of Neurology, University of Heidelberg, Heidelberg, Germany.
  • Tenembaum S National Pediatric Hospital Dr. Juan P. Garrahan, Ciudad de Buenos Aires, Argentina.
  • Paul F Experimental and Clinical Research Center Max Delbrueck Center for Molecular Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany.
  • Pittock S Department of Neurology, Mayo Clinic, Rochester, Minnesota, United States.
  • Marignier R Pathologies de la Myéline et Neuro-inflammation, Hôpital Neurologique Pierre Wertheimer Hospices Civils de Lyon, Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle, INSERM U1028, CNRS UMR 5292, Lyon 1 University, Center for Research in Neuroscience of Lyon, Lyon, France.
  • Jacob A Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom; Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom; Department of Neurology, The Cleveland Clinic Abu Dhabi, United Arab Emirates. Electronic address: anu.jacob@thewaltoncentre.nhs.uk.
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  • 2020-07-07
Published in:
  • Multiple sclerosis and related disorders. - 2020
English 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.
Language
  • English
Open access status
closed
Identifiers
Persistent URL
https://sonar.ch/global/documents/95315
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