Rituximab in refractory and non-refractory myasthenia: A retrospective multicenter study

Introduction: Few data are available about the effect of rituximab (RTX) on refractory (RM) and non-refractory (NRM) myasthenia. Methods: This retrospective multicenter study involved 13 RM and 7 NRM patients treated with sequential RTX infusions over 2 years, on average. RTX was used as a substitute for corticosteroids in NRM patients. Disability was assessed using the annualized relapse rate (ARR) and Myasthenia Gravis Foundation of America (MGFA) scores. Results: RTX induction decreased the ARR from 2.1 to 0.3 (P < 0.001), and lowered MGFA scores from 53b to 4b0 in RM patients, and from 1.9 to 0.1 (P < 0.001) and 4b2b to 3b0 in NRM patients. No side effects were reported in either group, except for 1 case of spondylodiscitis 1 year after the last RTX infusion. Within a year after RTX induction, complete corticosteroid withdrawal was obtained in 7 RM and 4 NRM patients. Conclusions: RTX is efficacious and well-tolerated. Its use allows for dose reduction or withdrawal of corticosteroids. Muscle Nerve, 2012