背景:利妥昔单抗(RTX)是一种抑制B细胞活性的单克隆抗CD20嵌合抗体。然而,它是一种快速起效的传统免疫调节药物的有吸引力的替代品,靶向治疗在许多神经炎性疾病中具有越来越多的疗效和耐受性的证据。我们讨论了在神经系统疾病中使用RTX的科学证据,以及剂量,安全,和处方的其他实用元素。
目的:本研究旨在评估和关联RTX对免疫介导的神经系统疾病的影响。
目的:本研究的主要目的是确定使用RTX治疗的患者在以下情况下的结局:重症肌无力(MG),自身免疫性脑炎,多发性硬化症(MS),视神经脊髓炎谱系障碍(NMOSD),髓鞘少突胶质细胞糖蛋白抗体病(MOGAD),免疫介导的周围神经病变,和炎症性肌肉疾病。次要目标是评估用RTX治疗的患者的药物不良反应。
方法:这是一项在三级护理中心进行的前瞻性观察性研究。对2022年5月至2024年5月期间的数据进行了分析。在开始研究之前获得了机构伦理委员会的批准,并获得所有患者的书面知情同意书.
结论:本研究共纳入56例患者。患者按疾病分布如下:MG(17),MS(11),NMOSD(10),MOGAD(7),免疫介导的周围神经病变(6),自身免疫性脑炎(3),和炎症性肌肉疾病(2)。然而,自身免疫性脑炎组1例患者失访.所有患者的症状都得到了改善,除1例炎症性肌肉疾病组复发患者外,无复发事件报道.在输液过程中,一些药物不良反应,如寒战和严酷,被观察到,两名患者出现了严重的副作用,如Pott病和隐源性机化性肺炎。然而,总的来说,利妥昔单抗显示出作为上述神经学免疫介导的疾病的标签外免疫抑制治疗的希望。
BACKGROUND: Rituximab (RTX) is a monoclonal anti-CD20 chimeric antibody that inhibits B cell activity. However, it is an appealing substitute for traditional immunomodulatory drugs as a swiftly acting, targeted therapy with mounting evidence of efficacy and tolerance in numerous neuroinflammatory conditions. We discuss the scientific evidence for the use of RTX in neurological illnesses, as well as the dose, safety, and other practical elements of prescription.
OBJECTIVE: This study aims to assess and correlate the effects of RTX on immune-mediated neurological disorders.
OBJECTIVE: The primary objective of this study is to determine the outcomes in patients treated with RTX for the following conditions: myasthenia gravis (MG), autoimmune encephalitis, multiple sclerosis (MS), neuromyelitis optica spectrum disorder (
NMOSD), myelin oligodendrocyte glycoprotein antibody disease (MOGAD), immune-mediated peripheral neuropathy, and inflammatory muscle disease. The secondary objective is to assess adverse drug reactions in patients treated with RTX.
METHODS: This is a prospective observational study conducted at a tertiary care centre. The data were analyzed for the period from May 2022 to May 2024. Approval was obtained from the institutional ethics committee before commencing the study, and written informed consent was obtained from all patients.
CONCLUSIONS: A total of 56 patients were included in the study. The distribution of patients according to diseases is as follows: MG (17), MS (11),
NMOSD (10), MOGAD (7), immune-mediated peripheral neuropathy (6), autoimmune encephalitis (3), and inflammatory muscle disease (2). However, one patient was lost to follow-up in the autoimmune encephalitis group. All patients experienced improvements in symptoms, and no relapse episodes have been reported except for one patient who had a relapse in the inflammatory muscle disease group. During the infusion process, some adverse drug reactions, such as chills and rigors, were observed, and two patients experienced major side effects, such as Pott\'s disease and cryptogenic organizing pneumonia. Nevertheless, overall, rituximab shows promise as an off-label immunosuppressive treatment for the aforementioned neurological immune-mediated diseases.