Efficacy of different rituximab therapeutic strategies in patients with neuromyelitis optica spectrum disorders

被引：73

作者：

Novi, Giovanni ^{[1
,2
]}

Bovis, Francesca ^{[3
]}

Capobianco, Marco ^{[4
,5
]}

Frau, Jessica ^{[6
]}

Mataluni, Giorgia ^{[7
]}

Curti, Erica ^{[8
]}

Zuliani, Luigi ^{[9
]}

Cavalla, Paola ^{[10
]}

Brambilla, Laura ^{[11
]}

Annovazzi, Pietro ^{[12
]}

Repice, Anna Maria ^{[13
]}

Lanzillo, Roberta ^{[14
]}

Esposito, Sabrina ^{[15
]}

Benedetti, Luana ^{[1
,2
]}

Maietta, Ilaria ^{[3
]}

Sica, Francesco ^{[16
]}

Buttari, Fabio ^{[16
]}

Malucchi, Simona ^{[4
,5
]}

Fenu, Giuseppe ^{[6
]}

Landi, Doriana ^{[7
]}

Bosa, Chiara ^{[17
]}

Realmuto, Sabrina ^{[4
,5
]}

Malentacchi, Maria ^{[18
]}

Granella, Franco ^{[8
]}

Signori, Alessio ^{[3
]}

Bonavita, Simona ^{[15
]}

Uccelli, Antonio ^{[1
,2
]}

Sormani, Maria Pia ^{[2
,3
]}

Nozzolillo, Agostino ^{[19
]}

Gallo, Fabio ^{[20
]}

Signoriello, Elisabetta ^{[21
]}

Clerici, Valentina Torri ^{[22
]}

La Gioia, Sara ^{[23
]}

Cocco, Eleonora ^{[6
]}

Sartori, Arianna ^{[24
]}

Rasia, Sarah ^{[25
]}

Cordioli, Cinzia ^{[25
]}

Barone, Stefania ^{[26
]}

Solaro, Claudio ^{[27
]}

Nociti, Viviana ^{[28
]}

Gobbi, Claudio ^{[29
]}

机构：

[1] Univ Genoa, Dept Neurosci Rehabil Ophthalmol Genet Maternal &, Genoa, Italy

[2] Osped Policlin San Martino IRCCS, Genoa, Italy

[3] Univ Genoa, Dept Hlth Sci DISSAL, Sect Biostat, Genoa, Italy

[4] AOU San Luigi, SCDO Neurol, Orbassano, Italy

[5] AOU San Luigi, Ctr Riferimento Reg Sclerosi Multipla, Orbassano, Italy

[6] Univ Cagliari, Dept Med Sci & Publ Hlth, Cagliari, Italy

[7] Univ Roma Tor Vergata, Dept Syst Med, Multiple Sclerosis Unit, Rome, Italy

[8] Univ Parma, Dept Med & Surg, Neurosci Unit, Parma, Italy

[9] Ca Foncello Hosp, ULSS Marca Trevigiana 2, Neurol Unit, Treviso, Italy

[10] City Hlth & Sci Univ Hosp Turin, MS Ctr, Dept Neurosci, Turin, Italy

[11] IRCCS Fdn, Neurol Inst C Besta, Dept Neuroimmunol & Neuromuscular Dis, Milan, Italy

[12] ASST Valle Olona, MS Ctr, PO Gallarate, Gallarate, VA, Italy

[13] Univ Hosp Careggi, Reg MS Ctr, Florence, Italy

[14] Univ Naples Federico II, Naples, Italy

[15] Univ Campania, Dept Neurol, Naples, Italy

[16] IRCCS Ist Neurol Mediterraneo Neurorned, Pozzilli, IS, Italy

[17] Univ Turin, Turin, Italy

[18] Univ Palermo, Expt Biomed & Clin Neurosci Dept BioNeC, Palermo, Italy

[19] Univ Naples Federico II, Multiple Sclerosis Ctr, Dept Neurosci Reprod Sci & Odontostomatol, Naples, Italy

[20] Univ Genoa, Dept Hlth Sci, Sect Biostat, Genoa, Italy

[21] Univ Campania Luigi Vanvitelli, Div Neurol 2, Multiple Sclerosis Ctr, Naples, Italy

[22] IRCCS Fdn, Neuroimmunol & Neuromuscolar Dis Unit, Carlo Besta Neurol Inst, Milan, Italy

[23] Ctr Sclerosi Multipla ASST Papa Giovanni XXIII Be, Bergamo, Italy

[24] Univ Trieste, Neurol Clin, Dept Med Surg & Hlth Sci, Trieste, Italy

[25] ASST Spedali Civili, Multiple Sclerosis Ctr, PO Montichiari BS, Brescia, Italy

[26] Magna Graecia Univ Catanzaro, Inst Neurol, Catanzaro, Italy

[27] Mons Luigi Novarese, Dept Rehabil, Moncrivello, VC, Italy

[28] Univ Cattolica Sacro Cuore, Fdn Policlin Univ A Gemelli IRCCS, Rome, Italy

[29] Osped Regionale Lugano, Neuroctr Southern Switzerland, Lugano, Switzerland

来源：

MULTIPLE SCLEROSIS AND RELATED DISORDERS | 2019年 / 36卷

关键词：

Efficacy; Neuromyelitis optica; Rituximab; CLINICAL-COURSE; OUTCOMES; SAFETY;

D O I：

10.1016/j.msard.2019.101430

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Objective: To evaluate disease activity according to rituximab (RTX) induction and maintenance regimens in a multicenter real-life dataset of NMOSD patients. Methods: This is an observational-retrospective multicentre study including patients with NMOSD treated with RTX in 21 Italian and 1 Swiss centers. Demographics, relapse rate and adverse events over the follow-up were summarized taking into account induction strategy (two-1 g infusions at a 15-day interval (IND-A) vs. 375 mg/m2/week infusions for one month (IND-B)) and maintenance therapy (regimen A (M-A) with fixed time-points infusions vs. regimen B (M-B) based on cytofluorimetric driven reinfusion regimens, the least further subdivided according to CD19 + B cells (M-B1) or CD27 + memory B cells (M-B2) monitoring). Results: 131 subjects were enrolled, 127 patients completed the induction regimen and 119 patients had at least one follow-up visit and were included in the outcome analysis. Median follow-up was 1.7 years (range 0.1-11.6). Annualized relapse rate (ARR) was 1.7 in the year before RTX start and decreased to 0.19 during the follow-up. Both ARR and Time to first relapse ( raR) analysis showed a trend toward an increased disease activity for IND-B and M-A. No patients with MT-B2 experienced relapses during the follow-up. Number of relapses in the year before RTX initiation and having received a previous treatment were significantly associated with higher ARR and reduced TTFR in the multivariate analysis. Interpretation: We confirm RTX efficacy in NMOSD patients. Use of specific induction and maintenance protocols is warranted in order to foster RTX efficacy and to reduce costs and side effects.

引用

页数：9

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