Rituximab treatment of myasthenia gravis: A systematic review

@article{Tandan2017RituximabTO,
  title={Rituximab treatment of myasthenia gravis: A systematic review},
  author={Rup Tandan and Michael K. Hehir and Waqar Waheed and Diantha B. Howard},
  journal={Muscle \& Nerve},
  year={2017},
  volume={56}
}
Rituximab is a chimeric mouse/human anti‐CD20 monoclonal immunoglobulin. We reviewed the efficacy and safety of rituximab in 169 myasthenia gravis (MG) patients from case reports and series. Antibodies to the acetylcholine receptor (AChR) were present in 59% and muscle‐specific tyrosine kinase (MuSK) in 34%. Modified Myasthenia Gravis Foundation of America postintervention scale of minimal manifestations (MM) or better occurred in 44%, and combined pharmacologic and chronic stable remission in… Expand
Rituximab as treatment for anti-MuSK myasthenia gravis
TLDR
This study provides Class IV evidence that for patients with anti-MuSK MG, rituximab increased the probability of a favorable outcome. Expand
Rituximab in Myasthenia Gravis - Where do we stand?
TLDR
Rituximab provides a promising option for management of Myasthenia gravis, particularly in patients with muscle-specific kinase antibodies or those with refractory disease, and its optimal regimen in MG. Expand
Efficacy and safety of different dosages of rituximab for refractory generalized AChR myasthenia gravis: A meta-analysis
TLDR
Most of refractory MG patients with anti-AChR autoantibody were well responsive and tolerated to RTX treatment, and repeated application of lower dose of RTX was effective and might be more appropriate forRefractory AChR-MG patients with potential lower side effects. Expand
Efficacy of Rituximab in Refractory Generalized anti-AChR Myasthenia Gravis.
TLDR
These results provide data on the effect of RTX in patients with severe, refractory anti-AChR Abs generalized MG as well as an improvement of the MG Foundation of America Postintervention Status (MGFA-PIS). Expand
Rituximab in refractory myasthenia gravis: Extended prospective study results
TLDR
Sustained clinical improvement was associated with rituximab after 1 cycle, with prolonged time to relapse and reduction in steroid dosage. Expand
Differential response to rituximab in anti-AChR and anti-MuSK positive myasthenia gravis patients: a single-center retrospective study
TLDR
Rituximab treatment response is observed in both AChR+ and Mu SK+ patients supporting the role of B cell depletion in the management of MG, and MuSK+ MG patients may experience greater benefits, including earlier time to remission, fewer exacerbations and hospitalizations post-treatment. Expand
Effectiveness and Safety of Rituximab for Refractory Myasthenia Gravis: A Systematic Review and Single-Arm Meta-Analysis
  • Cong Zhao, Meng Pu, +4 authors Guangyun Zhang
  • Frontiers in Neurology
  • 2021
Background and Objective: Myasthenia gravis (MG) is an autoimmune neuromuscular disease. Nearly 10–30% of patients with MG are refractory to conventional therapy. Rituximab (RTX), a monoclonalExpand
Why is development of new treatments necessary for myasthenia gravis? Recent advances in clinical trials
  • T. Imai
  • Medicine
  • Neurology and Clinical Neuroscience
  • 2019
TLDR
The new drugs and their latest development are introduced and the evidence for thymectomy in relation to the Japanese clinical guidelines for MG is discussed. Expand
Immunotherapy in myasthenia gravis in the era of biologics
TLDR
Targeted immunotherapy seems to be the most promising therapeutic approach in MG because it can effectively overcome the limitations of current nonspecific immunotherapies and has the potential to induce remission. Expand
Myasthenia Gravis Treatment Updates
TLDR
The prognosis of MG patients has improved remarkably due to a better understanding of the heterogeneity of the disease and the appearance of new therapeutic options and approaches, however, side effects are not infrequent and around 10% of patients are refractory to conventional treatments, showing the need to develop new and more specific drugs. Expand
...
1
2
3
4
5
...

References

SHOWING 1-10 OF 100 REFERENCES
Long-term benefit of rituximab in MuSK autoantibody myasthenia gravis patients
TLDR
The experience with the sustained effects of rituximab in nine refractory MuSK+ patients in a follow-up period ranging from 2 to 5.5 years is reported. Expand
Response of patients with refractory myasthenia gravis to rituximab: a retrospective study
TLDR
The hypothesis that rituximab is beneficial and well tolerated in managing refractory myasthenia gravis and nearly doubles published cases is supported and it is proposed that B-cell-directed therapies may become an attractive option and suggest pursuit of a prospective trial. Expand
Long-lasting treatment effect of rituximab in MuSK myasthenia
TLDR
In view of the long-lasting benefit observed in MuSK+MG patients, it is recommended to use rituximab as an early therapeutic option in this group of patients with MG if they do not respond to prednisone. Expand
Rituximab for myasthenia gravis Three case reports and review of the literature
TLDR
Preliminary data on the efficacy and safety of rituximab are encouraging and that further studies in MG seem warranted, and the anecdotal literature on ritUXimab for MG is reviewed. Expand
Response to Therapy in Myasthenia Gravis with Anti‐MuSK Antibodies
TLDR
In this and others' experience, MuSK‐positive MG markedly improves with IS therapy, although, in comparison with the AChR‐positive disease, it is characterized by a lower remission rate, as a higher proportion of patients remain dependent on treatment. Expand
Use and monitoring of low dose rituximab in myasthenia gravis
TLDR
Rituximab at a dose of 1 g appears to be beneficial in the treatment of patients with severe myasthenia gravis and serial monitoring of peripheral blood B lymphocytes seems to be useful in guiding the need for further RTX therapy. Expand
Rituximab for the Treatment of Thymoma-Associated and De Novo Myasthenia Gravis: 3 Cases and Review
TLDR
Observations support the concept that rituximab may be helpful for the treatment of Myasthenia gravis, andRemissions in patients with or without thymoma are achievable with ritUXimab given in combination with commonly used modalities. Expand
Sustained response to Rituximab in anti-AChR and anti-MuSK positive Myasthenia Gravis patients
TLDR
The results of treatment with Rituximab in six severe, non-responder MG patients improved dramatically, with no side effects, and no significant changes in IgG4 were found that could explain the different outcome observed between these two groups. Expand
Prolonged B‐Cell Depletion in MuSK Myasthenia Gravis Following Rituximab Treatment
TLDR
This MuSK-MG patient had profound, prolonged B cell depletion 3 years after receiving RTX, and clinicians need to be aware of the possibility of prolonged b cell depletion, particularly when it is combined with other immunosuppressives. Expand
Rituximab in the management of refractory myasthenia gravis
TLDR
Patients with refractory MG appeared to respond to rituximab in this small, retrospective study, and this result suggests that a larger, prospective trial is indicated. Expand
...
1
2
3
4
5
...