Treatment of MOG-IgG-associated disorder with rituximab: An international study of 121 patients.

Whittam, Daniel H, Cobo-Calvo, Alvaro, Lopez-Chiriboga, A Sebastian, Pardo, Santiago, Gornall, Matthew, Cicconi, Silvia ORCID: 0000-0001-5507-6203, Brandt, Alexander, Berek, Klaus, Berger, Thomas, Jelcic, Ilijas
et al (show 52 more authors) (2020) Treatment of MOG-IgG-associated disorder with rituximab: An international study of 121 patients. Multiple sclerosis and related disorders, 44. 102251-.

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OBJECTIVE:To assess the effect of anti-CD20 B-cell depletion with rituximab (RTX) on relapse rates in myelin oligodendrocyte glycoprotein antibody-associated disorder (MOGAD). METHODS:Retrospective review of RTX-treated MOGAD patients from 29 centres in 13 countries. The primary outcome measure was change in relapse rate after starting rituximab (Poisson regression model). RESULTS:Data on 121 patients were analysed, including 30 (24.8%) children. Twenty/121 (16.5%) were treated after one attack, of whom 14/20 (70.0%) remained relapse-free after median (IQR) 11.2 (6.3-14.1) months. The remainder (101/121, 83.5%) were treated after two or more attacks, of whom 53/101 (52.5%) remained relapse-free after median 12.1 (6.3-24.9) months. In this 'relapsing group', relapse rate declined by 37% (95%CI=19-52%, p<0.001) overall, 63% (95%CI=35-79%, p = 0.001) when RTX was used first line (n = 47), and 26% (95%CI=2-44%, p = 0.038) when used after other steroid-sparing immunotherapies (n = 54). Predicted 1-year and 2-year relapse-free survival was 79% and 55% for first-line RTX therapy, and 38% and 18% for second-/third-line therapy. Circulating CD19+B-cells were suppressed to <1% of total circulating lymphocyte population at the time of 45/57 (78.9%) relapses. CONCLUSION:RTX reduced relapse rates in MOGAD. However, many patients continued to relapse despite apparent B-cell depletion. Prospective controlled studies are needed to validate these results.

Item Type: Article
Uncontrolled Keywords: Myelin oligodendrocyte glycoprotein, MOG, Rituximab, Neuromyelitis optica, Optic neuritis
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Clinical Directorate
Faculty of Health and Life Sciences > Institute of Infection, Veterinary and Ecological Sciences
Depositing User: Symplectic Admin
Date Deposited: 23 Nov 2021 10:14
Last Modified: 18 Jan 2023 22:56
DOI: 10.1016/j.msard.2020.102251
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