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Rituximab review

Discussion in 'Other Health News and Research' started by Ecoclimber, Jul 31, 2013.

  1. Ecoclimber

    Ecoclimber Senior Member

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    Mercer Island Wa
    Rituximab review


    Castillo-Trivino T, Braithwaite D, Bacchetti P, Waubant E. Rituximab in relapsing and progressive forms of multiple sclerosis: a systematic review. PLoS One. 2013 Jul 2;8(7):e66308

    BACKGROUND:
    Rituximab is an anti-CD20 monoclonal antibody approved for non Hodgkin lymphoma and rheumatoid arthritis. It is being considered for the treatment of MS.

    OBJECTIVES:

    To evaluate the efficacy and safety of rituximab for MS treatment.

    DATA COLLECTION:

    Studies were selected if they were clinical trials, irrespective of the dosage or combination therapies.

    MAIN RESULTS:

    Four studies with a total of 599 patients were included. One assessed the efficacy of rituximab for primary progressive (PP) MS while the other three focused on relapsing-remitting (RR) MS.

    In the PPMS study, rituximab delayed time to confirmed disease progression (CDP) in pre-planned sub-group analyses. The increase in T2 lesion volume was lower in the rituximab group at week 96 compared with placebo.

    For the RRMS studies, an open-label phase I study found that rituximab reduced the annualized relapse rate to 0.25 from pre-therapy baseline to week 24, while in the randomized placebo-controlled phase II trial, annualized relapse rates were 0.37 in the rituximab group and 0.84 in the placebo group (p = 0.04) at week 24.

    Rituximab dramatically reduced the number of gadolinium-enhancing lesions on brain MRI scans for both RRMS studies.

    Off-label rituximab as an add-on therapy in patients with breakthrough disease on first-line agents was associated with an 88% reduction when comparing the mean number of gadolinium-enhancing lesions prior to and after the treatment.

    Although frequent adverse events classified as mild or moderate occurred in up to 77% of the patients, there were no grade 4 infusion-related adverse events. AUTHOR’S

    CONCLUSION:
    Despite the frequent mild/moderate adverse events related to the drug, rituximab appears overall safe for up to 2 years of therapy and has a substantial impact on the inflammatory disease activity (clinical and/or radiological) of RRMS. The effect of rituximab on disease progression in PPMS appears to be marginal.

    [​IMG]

    Anti-CD20 antibodies inhibit relapsing disease but does not appear to inhibit non-relapsing progressive MS

    For Comments from the Mouse Doctors Click Below:
    http://multiple-sclerosis-research.blogspot.co.uk/2013/07/rituximab-review.html
    Since this deals with an autoimmune disease, it is interesting comments for MS
    Eco
     
    Esther12, Bob and Sasha like this.

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