Rituximab in refractory myasthenia gravis: a prospective, open-label study with long-term follow-up

We examined the clinical effectiveness of rituximab in fourteen patients with refractory myasthenia gravis ( MG). Manual muscle testing ( MMT) score was recorded at baseline and followed during the course of the study. Steroid dose, frequency of intravenous immunoglobulin ( IVIG) infusions, and plasma exchange ( PLEX) were also monitored throughout the duration of the study. All patients responded dramatically to rituximab, as measured by a change in MMT score, prednisone dose, or the frequency of IVIG infusions or PLEX. Rituximab appears safe and effective for the treatment of refractory MG. It should be considered as a therapeutic option in refractory patients.