Treatment of MOG-IgG-associated disorder with rituximab: An international study of 121 patients.
Treatment of MOG-IgG-associated disorder with rituximab: An international study of 121 patients.
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DOI：
10.1016/j.msard.2020.102251
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发表时间：
2020-09
影响因子：
4
通讯作者：
Jacob A
中科院分区：
文献类型：
--
作者：
Whittam DH;Cobo-Calvo A;Lopez-Chiriboga AS;Pardo S;Gornall M;Cicconi S;Brandt A;Berek K;Berger T;Jelcic I;Gombolay G;Oliveira LM;Callegaro D;Kaneko K;Misu T;Capobianco M;Gibbons E;Karthikeayan V;Brochet B;Audoin B;Mathey G;Laplaud D;Thouvenot E;Cohen M;Tourbah A;Maillart E;Ciron J;Deschamps R;Biotti D;Rostasy K;Neuteboom R;Hemingway C;Forsyth R;Matiello M;Webb S;Hunt D;Murray K;Hacohen Y;Lim M;Leite MI;Palace J;Solomon T;Lutterotti A;Fujihara K;Nakashima I;Bennett JL;Pandit L;Chitnis T;Weinshenker BG;Wildemann B;Sato DK;Kim SH;Huda S;Kim HJ;Reindl M;Levy M;Jarius S;Tenembaum S;Paul F;Pittock S;Marignier R;Jacob A
旨在评估利妥昔单抗 (RTX) 消除抗 CD20 B 细胞对髓磷脂少突胶质细胞糖蛋白抗体相关性疾病 (MOGAD) 复发率的影响。对来自 13 个国家 29 个中心的 RTX 治疗的 MOGAD 患者进行回顾性评价。主要结果指标是开始使用利妥昔单抗后复发率的变化（泊松回归模型）。分析了 121 名患者的数据，其中包括 30 名 (24.8%) 儿童。 20/121 (16.5%) 在一次发作后接受治疗，其中 14/20 (70.0%) 在中位 (IQR) 11.2 (6.3–14.1) 个月后保持无复发。其余患者 (101/121, 83.5%) 在两次或多次发作后接受治疗，其中 53/101 (52.5%) 在中位 12.1 (6.3–24.9) 个月后仍未复发。在这个“复发组”中，总体复发率下降了 37% (95%CI=19–52%, p<0.001)，当 RTX 用于一线治疗 (n = 47) 时，复发率下降了 63% (95%CI=35–79%, p = 0.001)，当在其他药物之后使用时，复发率下降了 26% (95%CI=2–44%, p = 0.038)。节省类固醇的免疫疗法（n = 54）。一线 RTX 治疗的预测 1 年和 2 年无复发生存率分别为 79% 和 55%，二线/三线治疗的预测 1 年和 2 年无复发生存率分别为 38% 和 18%。 45/57 (78.9%) 复发时，循环 CD19+B 细胞被抑制至总循环淋巴细胞群的 1% 以下。 RTX 降低了 MOGAD 的复发率。然而，尽管 B 细胞明显减少，许多患者仍继续复发。需要前瞻性对照研究来验证这些结果。
To assess the effect of anti-CD20 B-cell depletion with rituximab (RTX) on relapse rates in myelin oligodendrocyte glycoprotein antibody-associated disorder (MOGAD). 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). 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. 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.
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影响因子：
5.8
作者：
Martinez-Yelamos, S.;Martinez-Yelamon, A.;Arbizu, Tx
通讯作者：
Arbizu, Tx
影响因子：
--
作者：
Jacob, Anu;Weinshenker, Brian G.;Cree, Bruce A. C.
通讯作者：
Cree, Bruce A. C.
影响因子：
29
作者：
Kim, Su-Hyun;Jeong, In Hye;Kim, Ho Jin
通讯作者：
Kim, Ho Jin
影响因子：
4.4
作者：
Lindsey, J. W.;Meulmester, K. M.;Wolinsky, J. S.
通讯作者：
Wolinsky, J. S.
影响因子：
9.9
作者：
Kitley, Joanna;Woodhall, Mark;Vincent, Angela
通讯作者：
Vincent, Angela