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Reduced inflammation in relapsing-remitting multiple sclerosis after therapy switch to rituximab
Department of Pharmacology and Clinical Neuroscience, Unit of Neurology, Östersund, Umeå University, Umeå, Sweden.
Örebro University, School of Medical Sciences. Department of Neurology.
Department of Pharmacology and Clinical Neuroscience, Unit of Neurology, Östersund, Umeå University, Umeå, Sweden.
Unit of Research, Education and Development, Region Jämtland Härjedalen, Sweden.
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2016 (English)In: Neurology, ISSN 0028-3878, E-ISSN 1526-632X, Vol. 87, no 2, 141-147 p.Article in journal (Refereed) Published
Abstract [en]

Objective: To describe the effects of switching treatment from ongoing first-line injectable therapies to rituximab on inflammatory activity measured by MRI and levels of CSF neurofilament light chain (CSF-NFL) in a cohort of patients with clinically stable relapsing-remitting multiple sclerosis (RRMS).

Method: Seventy-five patients with clinically stable RRMS treated with the first-line injectables interferon-β (IFN-β) and glatiramer acetate (GA) at 3 Swedish centers were switched to rituximab in this open-label phase II multicenter study. After a run-in period of 3 months, 2 IV doses of 1,000 mg rituximab were given 2 weeks apart followed by repeated clinical assessment, MRI, and CSF-NFL for 24 months.

Results: The mean cumulated number of gadolinium-enhancing lesions per patient at months 3 and 6 after treatment shift to rituximab was reduced compared to the run-in period (0.028 vs 0.36, p = 0.029). During the first year after treatment shift, the mean number of new or enlarged T2 lesions per patient was reduced (0.01 vs 0.28, p = 0.004) and mean CSF-NFL levels were reduced by 21% (p = 0.01).

Conclusions: For patients with RRMS, a treatment switch from IFN or GA to rituximab is associated with reduced inflammatory activity measured by MRI and CSF-NFL.

Classification of evidence: This study provides Class IV evidence that rituximab has an equal or superior effect in reducing inflammatory activity in RRMS measured by MRI and CSF-NFL compared to first-line injectables during the first year after treatment shift.

Place, publisher, year, edition, pages
Philadelphia, USA: Lippincott Williams & Wilkins, 2016. Vol. 87, no 2, 141-147 p.
National Category
Neurology
Research subject
Neurology
Identifiers
URN: urn:nbn:se:oru:diva-50951DOI: 10.1212/WNL.0000000000002832ISI: 000381470700032PubMedID: 27316241Scopus ID: 2-s2.0-84979021541OAI: oai:DiVA.org:oru-50951DiVA: diva2:939859
Note

Funding Agencies:

County Council of Västerbotten

County Council of Jämtland

County Council of Örebro

Unit of Research, Education and Development, Region Jämtland Härjedalen, "Syskonen Perssons Donationsfond"

Department of Clinical Neuroscience at Umeå University

Available from: 2016-06-20 Created: 2016-06-20 Last updated: 2017-10-17Bibliographically approved

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