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oai:repisalud.isciii.es:20.500.12105/225192024-11-28T18:27:04Zcom_20.500.12105_15322com_20.500.12105_2051col_20.500.12105_16962col_20.500.12105_16967col_20.500.12105_16978
Repisalud author Cortes-Vicente, Elena author Rojas-Garcia, Ricard author Diaz-Manera, Jordi author Querol, Luis author Casasnovas, Carlos author Guerrero-Sola, Antonio author Luis Munoz-Blanco, Jose author Eulalio Barcena-Llona, Jose author Marquez-Infante, Celedonio author Pardo, Julio author Maria Martinez-Fernandez, Eva author Uson Martin, Mercedes author Oliva-Nacarino, Pedro author Sevilla, Teresa author Illa, Isabel 2024-09-06T09:53:38Z 2024-09-06T09:53:38Z 2018-06 Cortes-Vicente E, Rojas-Garcia R, Diaz-Manera J, Querol L, Casasnovas C, Guerrero-Sola A, et al. The impact of rituximab infusion protocol on the long-term outcome in anti-MuSK myasthenia gravis. Ann Clin Transl Neurol. 2018 Jun;5(6):710-6. 10.1002/acn3.564 2328-9503 Annals of Clinical and Translational Neurology http://hdl.handle.net/20.500.13003/17162 29928654 L621692964 2-s2.0-85045397299 https://hdl.handle.net/20.500.12105/22519 434349700005 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). Interpretation: This 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. eng The impact of rituximab infusion protocol on the long-term outcome in anti-MuSK myasthenia gravis research article