Efficacy of Rituximab in Patients with Secondary Progressive Multiple Sclerosis, Primary Progressive Multiple Sclerosis and Neuromyelitis Optica with Individual Treatment Cycles According to Peripheral B-Cell Return (P04.145)
| العنوان: | Efficacy of Rituximab in Patients with Secondary Progressive Multiple Sclerosis, Primary Progressive Multiple Sclerosis and Neuromyelitis Optica with Individual Treatment Cycles According to Peripheral B-Cell Return (P04.145) |
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| المؤلفون: | Volker Limmroth, Sarah Bernsen, Susanne Sorgalla, Kathrin Gerbershagen |
| المصدر: | Neurology. 78:P04.145-P04.145 |
| بيانات النشر: | Ovid Technologies (Wolters Kluwer Health), 2012. |
| سنة النشر: | 2012 |
| مصطلحات موضوعية: | CD20, medicine.medical_specialty, Neuromyelitis optica, biology, business.industry, medicine.disease, Peripheral, medicine.anatomical_structure, Internal medicine, medicine, biology.protein, Secondary progressive multiple sclerosis, Rituximab, Neurology (clinical), Dosing, business, Adverse effect, B cell, medicine.drug |
| الوصف: | Objective: To evaluate a standardised treatment protocol (375mg/m2 iv) given once according to the individual B-cell return. Background Rituximab, a monoclonal antibody, selectively depleting CD20+ B cells, has demonstrated efficacy in reducing disease activity in relapsing remitting MS, in subgroups of primary progressive MS and Neuromyelitis optica. Case studies suggest that the recurrence of B-lymphocytes can be correlated with the reactivation of inflammatory activity. Design/Methods: 15 patients (11 SPMS, 1 PPMS, 3 NMO) who failed first line therapy received 375 mg/m2 rituximab iv. Blood samples were taken before, after 4 months, then every 2 months. Patients received next course as soon as B-lymphocyte counts increased. Primary endpoints were confirmed disease progression measured by EDSS-increase and paraclinical MRI progression. Secondary endpoints were annualized relapse rate and safety parameters. Results: 11 patients received three doses of rituximab, the remaining patients two, four, five and six courses. Time between the courses varied according to B-cell count between month four and twelve. EDSS was registered before the first course and every following (from 2.5 to 8.0). Patients showed a decreased mean annualized relapse rate (from 1.67 to 0.73) and stabilization in mean EDSS score (from 5.6 to 5.66). Gadolinium enhancing lesions were registered in 5 patients before initiating therapy, after the first two courses of Rituximab, one patient showed inflammatory MRI lesions. Three patients showed paraclinical progression on MRI. Adverse effects occured as mild infections, no severe adverse effects. Conclusions: In all 15 patients Rituximab reduced inflammatory brain lesions, clinical relapses and showed a stabilizing of EDSS and paraclinical progression. No severe side effects occurred, observation phase up to 224 weeks. Although the patient population is small and heterogenous the positive results of previous studies regarding efficacy can be confirmed. This is to our knowledge the first report showing that the standard dosing protocol according to peripheral B-cell return might be effective and safe. Disclosure: Dr. Bernsen has nothing to disclose. Dr. Sorgalla has nothing to disclose. Dr. Gerbershagen has received personal compensation for activities with Merck Serono, Sanofi-Aventis Pharmaceuticals, Inc., Bayer Pharmaceuticals Corporation, Biogen Idec and Bionorica AG as a speaker. Dr. Limmroth has received personal compensation for activities with Bayer, Biogen Idec, Novartis, Roche, Sanofi-ventis, Serono, and Teva.Dr. Limmroth has received research support from Bayer, Biogen Idec, Novartis, Roche, Sanofi-Aventis, Serono, and Teva. |
| تدمد: | 1526-632X 0028-3878 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_________::4ed5dd2ccbc2101634d2cf9769cc2108Test https://doi.org/10.1212/wnl.78.1_meetingabstracts.p04.145Test |
| رقم الانضمام: | edsair.doi...........4ed5dd2ccbc2101634d2cf9769cc2108 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 1526632X 00283878 |
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