Rituximab Shows Clinical Benefit in Treating Both Progressive and Relapsing-Remitting MS

Last month, a retrospective observational study was published in PLOS One that investigated the safety and efficacy of rituximab in patients with progressive MS (PMS) and relapsing-remitting MS (RRMS) in a single tertiary care center in Switzerland.

The study was based on clinical and radiological data that were collected within the MS registry of the Neurocenter of Southern Switzerland. The registry was founded in 2007 and later revised in February 2018. Patients were included within the study if they met the following criteria: a diagnosis of MS, at least 1 prior infusion of rituximab, and available clinical and radiological follow-up data.

In total, 82 MS patients were included within the analysis, with 43 (52.4%) RRMS patients and 39 (47.6%) PMS patients, respectively. All patients were given an initial rituximab induction dosage on day 1 and a second infusion on day 15 (1000 mg for each dose in 74 patients and 500 mg in 7 patients, respectively). Following this infusion, patients were put on a maintenance regimen and were given a third infusion at 9 months after the initial dose and every 6 months thereafter.

The time of the treatment was defined as the interval between the first rituximab infusion and the last available neurological examination, which were performed every 3 months after the initial infusion. Out of 339 rituximab infusions, only 10 resulted in adverse effects: 4 fevers, 1 myalgia, 2 nausea, 1 tachycardia and 2 swelling of buccal mucosa.

The number of observed relapses during rituximab treatment involved 3 patients, all with PMS at 6, 12, and 18 months since the start of the therapy. Overall, researchers found that there was no statistically significant difference between the 2 cohorts of patients in terms of the clinical and radiological effectiveness of rituximab treatment.

Researchers noted that the results of the study add to the evidence found in prior studies that support the use of rituximab in the treatment of MS, though rituximab is not approved to treat MS.

“Rituximab could present an additional effective, relatively cheap and safe therapy in the panel of existing MS treatments,” concluded the authors.

Reference

Scotti B, Disanto G, Sacco R, Guigli M, Zecca C, Gobbi C. Effectiveness and safety of rituximab in multiple sclerosis: an observational study from southern Switzerland. [Published online May 14, 2018.] PLoS One. doi.org/10.1371/journal.pone.0197415.