Contributions
Abstract: P1155
Type: Poster
Abstract Category: Therapy - disease modifying - 26 Immunomodulation/Immunosuppression
Objective: To evaluate the efficacy and safety of rituximab in multiple sclerosis in a clinical practice setting.
Methods: Clinical data for adult patients with multiple sclerosis (MS) treated with off-label rituximab at Nehme and Therese Tohme multiple sclerosis center in Lebanon between March 2008 and April 2017 were retrospectively collected from medical charts. The main efficacy outcomes were proportion of patients free from relapses, annualized relapse rate (ARR), disability progression as measured by Expanded Disability Status Scale (EDSS), and magnetic resonance imaging (MRI) activity. Adverse events (AEs) were also recorded.
Results: A total of 64 rituximab-treated patients were included: 45 relapsing-remitting MS (RRMS) and 19 progressive MS (n=12 secondary progressive MS (SPMS), n=1 primary progressive MS (PPMS), and n=2 relapsing-progressive MS (RPMS)). Patients were treated with 1000 or 2000mg rituximab IV every 6-12 months for a mean duration of 31±29 months. The subjects were 70.3% females with a mean age of 41.2±12.8 years, and mean disease duration of 7.7±6.5 years. During treatment, the ARR decreased from 1.2 at baseline to 0.09 in RRMS patients and from 0.3 to 0 in progressive MS patients. The mean EDSS remained unchanged in RRMS and increased by 1.8 in patients with progressive disease. Between baseline and last follow-up the percent of patients free from any new MRI lesions increased from 16% to 89% in the RRMS group and from 47% to 100% in the progressive group. Infusion-related AEs occurred during 6.5% of infusions and were all mild. A total of 24 AEs (37.5%) were recorded. Two of our rituximab-treated patients experienced serious AEs requiring surgical interventions: pyoderma gangrenosum vaginalis with perianal abscess and fistula, and increase in the size of a benign Grade I meningioma. No case of progressive multifocal leukoencephalopathy was detected.
Conclusion: Rituximab was well-tolerated and effective in reducing relapse rate and stabilizing disease in relapsing-remitting and progressive MS patients in our real-world clinical practice setting. Its efficacy persists with continued treatment, and is similar to that reported in a recent cohort in Sweden.
Disclosure:
Maya Zeineddine: Nothing to disclose
Nabil Ayyoubi: Nothing to disclose
Johny Nicolas: Nothing to disclose
Samia Khoury:Nothing to disclose
Bassem Yamout:Nothing to disclose
Abstract: P1155
Type: Poster
Abstract Category: Therapy - disease modifying - 26 Immunomodulation/Immunosuppression
Objective: To evaluate the efficacy and safety of rituximab in multiple sclerosis in a clinical practice setting.
Methods: Clinical data for adult patients with multiple sclerosis (MS) treated with off-label rituximab at Nehme and Therese Tohme multiple sclerosis center in Lebanon between March 2008 and April 2017 were retrospectively collected from medical charts. The main efficacy outcomes were proportion of patients free from relapses, annualized relapse rate (ARR), disability progression as measured by Expanded Disability Status Scale (EDSS), and magnetic resonance imaging (MRI) activity. Adverse events (AEs) were also recorded.
Results: A total of 64 rituximab-treated patients were included: 45 relapsing-remitting MS (RRMS) and 19 progressive MS (n=12 secondary progressive MS (SPMS), n=1 primary progressive MS (PPMS), and n=2 relapsing-progressive MS (RPMS)). Patients were treated with 1000 or 2000mg rituximab IV every 6-12 months for a mean duration of 31±29 months. The subjects were 70.3% females with a mean age of 41.2±12.8 years, and mean disease duration of 7.7±6.5 years. During treatment, the ARR decreased from 1.2 at baseline to 0.09 in RRMS patients and from 0.3 to 0 in progressive MS patients. The mean EDSS remained unchanged in RRMS and increased by 1.8 in patients with progressive disease. Between baseline and last follow-up the percent of patients free from any new MRI lesions increased from 16% to 89% in the RRMS group and from 47% to 100% in the progressive group. Infusion-related AEs occurred during 6.5% of infusions and were all mild. A total of 24 AEs (37.5%) were recorded. Two of our rituximab-treated patients experienced serious AEs requiring surgical interventions: pyoderma gangrenosum vaginalis with perianal abscess and fistula, and increase in the size of a benign Grade I meningioma. No case of progressive multifocal leukoencephalopathy was detected.
Conclusion: Rituximab was well-tolerated and effective in reducing relapse rate and stabilizing disease in relapsing-remitting and progressive MS patients in our real-world clinical practice setting. Its efficacy persists with continued treatment, and is similar to that reported in a recent cohort in Sweden.
Disclosure:
Maya Zeineddine: Nothing to disclose
Nabil Ayyoubi: Nothing to disclose
Johny Nicolas: Nothing to disclose
Samia Khoury:Nothing to disclose
Bassem Yamout:Nothing to disclose