title: Rituximab in refractory and non-refractory myasthenia: a retrospective multicenter study.
abstract: BACKGROUND
  Few data are available about the effect of rituximab (RTX) on refractory (RM) and non-refractory (NRM) myasthenia.
  
  
  METHODS
  This retrospective multicenter study involved 13 RM and 7 NRM patients treated with sequential RTX infusions over 2 years, on average. RTX was used as a substitute for corticosteroids in NRM patients. Disability was assessed using the annualized relapse rate (ARR) and Myasthenia Gravis Foundation of America (MGFA) scores.
  
  
  RESULTS
  RTX induction decreased the ARR from 2.1 to 0.3 (P < 0.001), and lowered MGFA scores from 5-3b to 4b-0 in RM patients, and from 1.9 to 0.1 (P < 0.001) and 4b-2b to 3b-0 in NRM patients. No side effects were reported in either group, except for 1 case of spondylodiscitis 1 year after the last RTX infusion. Within a year after RTX induction, complete corticosteroid withdrawal was obtained in 7 RM and 4 NRM patients.
  
  
  CONCLUSIONS
  RTX is efficacious and well-tolerated. Its use allows for dose reduction or withdrawal of corticosteroids.
authors.affiliation: Department of Neurology, University of Strasbourg, University Hospital of Hautepierre, 1 Avenue Molière, 67000 Strasbourg, France. nicolas.collongues@chru.strasbourg.fr
authors.forename: Nicolas
authors.initials: N
authors.lastname: Collongues
authors.forename: Olivier
authors.initials: O
authors.lastname: Casez
authors.forename: Arnaud
authors.initials: A
authors.lastname: Lacour
authors.forename: Christine
authors.initials: C
authors.lastname: Tranchant
authors.forename: Patrick
authors.initials: P
authors.lastname: Vermersch
authors.forename: Jérôme
authors.initials: J
authors.lastname: de Seze
authors.forename: Christine
authors.initials: C
authors.lastname: Lebrun
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000188:drug therapy* / Q000453:epidemiology* / Q000503:physiopathology; D012189:Retrospective Studies; D000069283:Rituximab
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000069283:Rituximab