Three papers on the use of Rituximab:
1 Review on use in Relapsing/Remitting MS (RRMS):
http://www.ncbi.nlm.nih.gov/pubmed/24310855
CONCLUSION:
There is not sufficient evidence to support the use of rituximab as a disease-modifying therapy for RRMS because only one RCT was included.
The quality of the study was limited due to high attrition bias, the small number of participants, and short follow-up.
The beneficial effects of rituximab for RRMS remain inconclusive. However, short-term treatment with a single course of rituximab was safe for most patients with RRMS.
Mild-to-moderate infusion-associated adverse events were common, as well as nasopharyngitis, upper respiratory tract infections, urinary tract infections and sinusitis.
The potential benefits of rituximab for treating RRMS need to be evaluated in large-scale studies that are of high quality along with long-term safety.
2 Use in paediatric central demyelinating disease:
http://www.ncbi.nlm.nih.gov/pubmed/24768216
CONCLUSION:
The use of rituximab in our pediatric neuromyelitis optica and multiple sclerosis cohort was overall safe and effective. Larger studies should confirm our observations.
3 Use in paediatric autoimmune and inflammatory disease:
http://www.ncbi.nlm.nih.gov/pubmed/24920861
CONCLUSION:
While limited by the retrospective nature of this analysis, our data support an off-label use of rituximab, although the significant risk of infectious complications suggests rituximab should be restricted to disorders with significant morbidity and mortality.
CLASSIFICATION OF EVIDENCE:
This study provides Class IV evidence that in pediatric autoimmune and inflammatory CNS disorders, rituximab improves neurologic outcomes with a 7.6% risk of adverse infections.
