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Article Dans Une Revue Multiple Sclerosis Journal Année : 2018

Efficacy of rituximab in refractory RRMS

Pierre Labauge
Marc Debouverie
  • Fonction : Auteur
  • PersonId : 762777
  • IdRef : 068986629
Caroline Papeix
Bruno Stankoff

Résumé

Objective: To investigate the efficacy of rituximab as rescue therapy in patients with relapsing-remitting multiple sclerosis (RRMS) and persistent disease activity confirmed by magnetic resonance imaging (MRI) despite immunosuppressive disease-modifying therapy (DMT). Methods: In this observational nationwide retrospective multicenter study, we first identified 351 off-label rituximab-treated patients through a cohort of 15,984 RRMS patients. In this group, we identified patients with disease activity prior to rituximab confirmed by MRI (one or more new T2 lesion and/or gadolinium-enhancing lesion) despite immunosuppressive DMT (fingolimod, natalizumab, or mitoxantrone) with a follow-up after rituximab initiation longer than 6 months. Outcome data were collected from the French Observatory of Multiple Sclerosis (OFSEP) register and medical charts. Results: A total of 50 patients were identified. Median rituximab treatment duration was 1.1 (0.5-6.4) year. Mean annualized relapse rate significantly decreased from 0.8 during last immunosuppressive DMT to 0.18 after rituximab ( p < 0.0001). While 72% of patients showed gadolinium-enhancing lesions on the last MRI performed during last immunosuppressive DMT, 8% of them showed gadolinium-enhancing lesions on the first MRI performed 6.1 (range 1.4-18.4) months after rituximab ( p < 0.0001). Conclusion: This study provides level IV evidence that rituximab reduces clinical and MRI disease activity in patients with active RRMS despite immunosuppressive DMT.
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Dates et versions

hal-02066062 , version 1 (13-03-2019)

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Pierre Durozard, Adil Maarouf, Clémence Boutière, Aurélie Ruet, Bruno Brochet, et al.. Efficacy of rituximab in refractory RRMS. Multiple Sclerosis Journal, 2018, 25 (6), pp.828-836. ⟨10.1177/1352458518772748⟩. ⟨hal-02066062⟩
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