Rituximab Studied as Add-On Therapy for New-Onset Myasthenia Gravis

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A single infusion of rituximab early after the onset of generalized myasthenia gravis improves outcomes at 16 weeks.

HealthDay News — A single infusion of rituximab early after the onset of generalized myasthenia gravis improves outcomes at 16 weeks, according to a study published online Sept. 19 in JAMA Neurology.

Fredrik Piehl, M.D., Ph.D., from the Karolinska University Hospital in Stockholm, and colleagues investigated the efficacy and safety of rituximab (500 mg; 25 patients) versus placebo (22 patients) as an add-on to standard of care for myasthenia gravis.

The researchers found that a greater proportion with rituximab had minimal disease manifestations at 16 weeks (71 percent in the rituximab group versus 29 percent in the placebo group; probability ratio, 2.48). There were no differences observed between the groups for secondary end points of changes in Myasthenia Gravis Activities of Daily Living and Myasthenia Gravis Quality of Life at 16 weeks and Quantitative Myasthenia Gravis at 24 weeks when censoring for rescue treatment (per-protocol analysis). However, there was a trend toward favoring active treatment when rescue treatment was taken into account. In the placebo group, rescue treatments were more frequent (4 percent with rituximab versus 36 percent with placebo). One patient in the placebo arm had a myocardial infarction with cardiac arrest, and one patient in the active arm experienced a fatal cardiac event.

“Treatment with rituximab can be considered early after onset of generalized myasthenia gravis to reduce the risk of disease worsening and/or need of additional therapies,” the authors write.

Several authors disclosed financial ties to the pharmaceutical and biotechnology industries.

Abstract/Full Text

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