Efficacy and safety of rituximab in refractory MG corroborated

In a French retrospective multicentre study, the efficacy and safety of rituximab as a second-line immunosuppressive treatment of steroid-dependent myasthenia gravis (MG) was corroborated [1]. Thus far, the probable benefit was based on a few small studies and anecdotal evidence.

Inclusion criteria for this retrospective study were age >18 years, MG with acetylcholine receptor (AchR) antibodies, MuSK antibodies, or significant decrement on single-fibre electromyography, MG Foundation of America (MGFA) score >II, refractory or steroid-dependent MG, and rituximab treatment.

Included were 27 patients from 6 French neurology centres: 19 had AchR-antibody-positive MG, 4 MuSK-antibody-positive MG, and 2 had seronegative MG. MGFA post-interventional score had improved in 81.4% of patients after 6 months of treatment (P<0.0001). A second measure of efficacy, the mean Garches’ score, increased from 65.29 to 84.23 after 6 months (P<0.0001). A third measure was a decrease of steroid use to <10 mg; this was reached by 66.6% of treated patients after 6 months. Adverse events were seen in 40% of patients: 18% had infections, 7% infusion reactions, 7% cytopenia, and 3.7% bradycardia. The study, although retrospective, confirms the efficacy of rituximab as shown in other centres.

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   1. Dos Santos A, et al. Abstract EPR1179, EAN 2020.

Posted on 10 September 20205 November 2020