Rituximab in refractory and non-refractory myasthenia: a retrospective multicenter study.

INTRODUCTION

Few data are available about the effect of rituximab (RTX) on refractory (RM) and non-refractory (NRM) myasthenia.

METHODS

This retrospective multicenter study involved 13 RM and 7 NRM patients treated with sequential RTX infusions over 2 years, on average. RTX was used as a substitute for corticosteroids in NRM patients. Disability was assessed using the annualized relapse rate (ARR) and Myasthenia Gravis Foundation of America (MGFA) scores.

RESULTS

RTX induction decreased the ARR from 2.1 to 0.3 (P < 0.001), and lowered MGFA scores from 5-3b to 4b-0 in RM patients, and from 1.9 to 0.1 (P < 0.001) and 4b-2b to 3b-0 in NRM patients. No side effects were reported in either group, except for 1 case of spondylodiscitis 1 year after the last RTX infusion. Within a year after RTX induction, complete corticosteroid withdrawal was obtained in 7 RM and 4 NRM patients.

CONCLUSIONS

RTX is efficacious and well-tolerated. Its use allows for dose reduction or withdrawal of corticosteroids.