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Title: | The Impact Of Rituximab Infusion Protocol On The Long-term Outcome In Anti-musk Myasthenia Gravis |
Author: | Cortés Vicente, Elena Rojas-Garcia, Ricard Díaz Manera, Jordi Querol, Luis Casasnovas Pons, Carlos Guerrero Sola, Antonio Muñoz Blanco, José Luis Bárcena Llona, José Eulalio Márquez Infante, Celedonio Pardo, Julio Martínez Fernández, Eva María Usón, Mercedes Oliva Nacarino, Pedro Sevilla, Teresa Illa Sendra, Isabel |
Keywords: | Malalties del sistema nerviós Assaigs clínics de medicaments Nervous system Diseases Drug testing |
Issue Date: | 1-Jun-2018 |
Publisher: | Wiley |
Abstract: | Objective: To evaluate whether the clinical benefit and relapse rates in anti-muscle-specific kinase (MuSK) myasthenia gravis (MG) differ depending on the protocol of rituximab followed. Methods: This retrospective multicentre study in patients with MuSK MG compared three rituximab protocols in terms of clinical status, relapse, changes in treatment, and adverse side effects. The primary effectiveness endpoint was clinical relapse requiring a further infusion of rituximab. Survival curves were estimated using Kaplan-Meier methods and survival analyses were undertaken using Cox proportional-hazards models. Results: Twenty-five patients were included: 11 treated with protocol 4 + 2 (375 mg/m(2)/4 weeks, then monthly for 2 months), five treated with protocol 1 + 1 (two 1 g doses 2 weeks apart), and nine treated with protocol 4 (375 mg/m(2)/4 weeks). Mean follow-up was 5.0 years (SD 3.3). Relapse occurred in 18.2%, 80%, and 33.3%, and mean time to relapse was 3.5 (SD 1.5), 1.1 (SD 0.4), and 2.5 (SD 1.4) years, respectively. Based on Kaplan-Meier estimates, patients treated with protocol 4 + 2 had fewer and later relapses than patients treated with the other two protocols (log-rank test P = 0.0001). Patients treated with protocol 1 + 1 had a higher risk of relapse than patients treated with protocol 4 + 2 (HR 112.8, 95% CI, 5.7-2250.4, P = 0.002). Patients treated with protocol 4 showed a trend to a higher risk of relapse than those treated with protocol 4 + 2 (HR 9.2, 95% CI 0.9-91.8, P = 0.059). InterpretationThis study provides class IV evidence that the 4 + 2 rituximab protocol has a lower clinical relapse rate and produces a more durable response than the 1 + 1 and 4 protocols in patients with MuSK MG. |
Note: | Reproducció del document publicat a: https://doi.org/10.1002/acn3.564 |
It is part of: | Annals of Clinical And Translational Neurology, 2018, vol. 5, num. 6, p. 710-716 |
URI: | http://hdl.handle.net/2445/123976 |
Related resource: | https://doi.org/10.1002/acn3.564 |
Appears in Collections: | Articles publicats en revistes (Ciències Clíniques) Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL)) |
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