Efficacy and safety of low-dose rituximab in preventing neuromyelitis optica spectrum disorder relapse
Journal Title: Eye Science (Yanke Xuebao) - Year 2023, Vol 38, Issue 3
Abstract
[Objective:] To evaluate the efficacy and safety of low-dose rituximab (RTX) in preventing neuromyelitis optica spectrum disorders (NMOSD). [Methods:] A prospective self-control trial was used to select a total of 38 patients clinically diagnosed as NMOSD from July 2020 to April 2021 for the study, and low-dose RTX was given for treatment. All patients underwent medical history, ophthalmic examination and serological test to record the annual recurrence rate (ARR), best corrected visual acuity (BCVA), combined autoantibodies and adjuvant therapy status. The BCVA was examined using Snellen eye chart, and the results were converted to logarithm of minimal angle resolution (logMAR). The patients were followed up for at least 12(17.29±2.2) months, and the last follow-up was taken as the time point of efficacy evaluation. The ARR and BCVA before and after treatment were compared. The relationship between relapse and age of onset, positivity for combination of autoimmune antibodies and autoimmune diseases was analyzed. The incidence of side effects and duration of additional therapy were recorded. [Results:] A total of 38 NMOSD patients (4 male/34 female, 61 involved eyes) were included in this study. The ages of onset was 12-60 years old, the median onset age was 23 (18-29.3) years. Duration of disease was 10-265 months, the median duration was 65 (48.3-101.0) months. Before treatment, the mean logMAR BCVA was (1.15±0.13), the mean logMAR BCVA after treatment was (1.54±0.39), showing no significant difference (t=1.120, P=0.267). The mean ARR before and after treatment were (1.50±0.86) and (0.12±0.07), respectively, with significant difference (t=8.304, P<0.001). The duration of additional treatment was (6.4±2.3) months. Five relapses in three patients were observed. There was no significant difference between on onset ages of relapsed patients and non-relapsed patients, the proportion of auto-immune antibody, and the proportion of auto-immune diseases (all P>0.05). Among 38 patients, 7 patients had side effects of infusion, which were relieved after slowing down the infusion speed of RTX or infusing added 5 mg of dexamethasone and no other obvious adverse reactions were seen during the follow-up. [Conclusions] Low-dose RTX can effectively clear B lymphocytes, prevent NMOSD recurrence and with good safety.
Authors and Affiliations
Mingming SUN, Huanfen ZHOU, Jie ZHAO, Lei ZHANG, Yuan ZHANG, Honglu SONG, Wenhao BAI, Xintong XU, Qian ZHANG, Qianhui LIANG, Xuemin WANG, Shihui WEI, Quangang XU
Keywords
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- EP ID EP764620
- DOI 10.12419/j.issn.1000-4432.2023.03.04
- Views 10
- Downloads 0
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