Efficacy of different rituximab therapeutic strategies in patients with neuromyelitis optica spectrum disorders
| Autor: | Ilaria Maietta, Antonio Uccelli, Erica Curti, Francesca Bovis, Marco Capobianco, Giorgia Mataluni, Giovanni Novi, Maria Pia Sormani, Pietro Annovazzi, Sabrina Realmuto, Sabrina Esposito, Roberta Lanzillo, Paola Cavalla, Luigi Zuliani, Fabio Buttari, Simona Malucchi, Maria Malentacchi, Simona Bonavita, Doriana Landi, Alessio Signori, Anna Maria Repice, Francesco Sica, Chiara Bosa, Jessica Frau, Franco Granella, Giuseppe Fenu, Laura Brambilla, Luana Benedetti |
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| Přispěvatelé: | Novi, Giovanni, Bovis, Francesca, Capobianco, Marco, Frau, Jessica, Mataluni, Giorgia, Curti, Erica, Zuliani, Luigi, Cavalla, Paola, Brambilla, Laura, Annovazzi, Pietro, Repice, Anna Maria, Lanzillo, Roberta, Esposito, Sabrina, Benedetti, Luana, Maietta, Ilaria, Sica, Francesco, Buttari, Fabio, Malucchi, Simona, Fenu, Giuseppe, Landi, Doriana, Bosa, Chiara, Realmuto, Sabrina, Malentacchi, Maria, Granella, Franco, Signori, Alessio, Bonavita, Simona, Uccelli, Antonio, Sormani, Maria Pia, Novi, G., Bovis, F., Capobianco, M., Frau, J., Mataluni, G., Curti, E., Zuliani, L., Cavalla, P., Brambilla, L., Annovazzi, P., Repice, A. M., Lanzillo, R., Esposito, S., Benedetti, L., Maietta, I., Sica, F., Buttari, F., Malucchi, S., Fenu, G., Landi, D., Bosa, C., Realmuto, S., Malentacchi, M., Granella, F., Signori, A., Bonavita, S., Uccelli, A., Sormani, M. P. |
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Multivariate analysis Efficacy Outcome and Process Assessment Settore MED/26 03 medical and health sciences 0302 clinical medicine Maintenance therapy Internal medicine medicine Humans Immunologic Factors In patient 030212 general & internal medicine Adverse effect Aged Retrospective Studies Neuromyelitis optica business.industry Multiple sclerosis General Medicine Middle Aged medicine.disease Health Care Regimen Outcome and Process Assessment Health Care Neurology Efficacy Neuromyelitis optica Rituximab Rituximab Female Neurology (clinical) business 030217 neurology & neurosurgery medicine.drug Follow-Up Studies |
| Popis: | 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 (TTFR) 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. |
| Databáze: | OpenAIRE |
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