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Rescue Therapy Using Rituximab for Multiple Sclerosis

Berenguer-Ruiz, Leticia MD; Sempere, Angel P. MD; Gimenez-Martinez, Juana MD; Gabaldon-Torres, Laura MD; Tahoces, Luisa MD; Sanchez-Perez, Rosa MD; Diaz-Marin, Carmen MD

doi: 10.1097/WNF.0000000000000156
Original Articles
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Objectives The aim of the study was to describe the effectiveness and safety data of rituximab in a group of patients with relapsing-remitting multiple sclerosis (MS) treated with rituximab due to failure of previous treatments or concomitant autoimmune diseases.

Methods This is an observational study. Rituximab was considered in case of failure of the second-line therapy, failure of the first-line therapy and a contraindication to second-line therapies, or concomitant autoimmune disease. Relapses, the Expanded Disability Status Scale, the EQ VAS, and magnetic resonance imaging activity were assessed.

Results This study included 12 patients with relapsing-remitting MS. The mean (range) age of the patients was 35 (19–54) years. Ten patients were treated with rituximab because of treatment failure, and 2 patients were treated with rituximab because of the development of idiopathic thrombocytopenic purpura. The mean (range) follow-up duration after beginning rituximab was 40 (18–72) months. Rituximab was well tolerated, because no patient experienced serious adverse reactions or discontinued treatment. During treatment with rituximab, no patient suffered a clinical relapse, and magnetic resonance imaging activity was not detected. The Expanded Disability Status Scale scores improved in 11 of 12 patients and remained stable in 1 patient. The EuroQol visual analogue scale scores improved in 8 of 9 patients in whom the EuroQol visual analogue scale was assessed.

Conclusions Treatment with rituximab seems to be safe and effective for some patients with relapsing-remitting MS who have failed to respond to first- and second-line therapies and may also be a useful option for patients with concomitant autoimmune disorders.

*Neurology Service, Hospital Marina Baixa, Villajoyosa; †Neurology Service, Hospital General Universitario de Alicante, Alicante; ‡Neurology Service, Hospital de Denia, Denia; and §Hematology Section, Hospital Marina Baixa, Villajoyosa, Spain.

Address correspondence and reprint requests to Angel Pérez Sempere, MD, Neurology Department, Hospital General Universitario de Alicante, Calle Pintor Baeza 12, Alicante 03010, Spain; E-mail: aperezs@me.com

Conflict of Interest and Source of Funding: A.P.S. has received compensation for serving on scientific advisory boards or in speaker's bureaus from Biogen Idec, Bayer Schering Pharma, Merck Serono, Novartis, Roche, Sanofi-Aventis, and Teva. R.S.-P. has received speaker honoraria from Almirall Pharmaceuticals and Sanofi-Aventis. L.B. has received speaker honoraria from Novartis and Teva. For the remaining authors none were declared.

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