Compared to CD19-positive B-cell monitoring, CD27-positive B-cell monitoring of reinfusion of the rituximab therapeutic regimen reduced the number of re-infusions with a comparable safety and efficacy profile.
Patients suffering from myelin oligodendrocyte glycoprotein-associated disorders (MOGAD) and neuromyelitis optica spectrum disorder (NMOSD) are widely administered B-cell-depleting agents; however, there is a lack of evidence-based information regarding treatment frequency and dosage.
This study investigated the treatment outcomes of rituximab (RTX) based on CD27-positive B-cell monitoring. The study concluded that the treatment regimen contributed to a reduction in the number of re-infusions of RTX in the context of CD19-positive B-cell monitoring and was associated with comparable safety and efficacy. The study findings are published in the journal Neurology and Therapy.
Baseline Characteristics of Study Participants
The study included a total of 19 NMOSD and MOGAD patients who were retrospectively analyzed. The mean age of the cohort was 52.74 ± 17.60 years, and most of the patients were female. The median follow-up duration was 7.64 years.
Rituximab Treatment Regimen and Clinical Effectiveness Criteria
RTX treatment in patients diagnosed with NMOSD and MOGAD depends on an individualized therapeutic approach. In this study, the treatment was initiated with two 1000 mg infusions at an interval of two weeks. The confirmation of the clinical effectiveness of RTX was indicated by a significant decline in the annualized relapse rate (ARR) from 2.37 to 0.08 and stabilization of the Expanded Disability Status Scale (EDSS).
Re-Treatment Criteria Based on B-Cell Monitoring
The study applied the re-treatment criteria based on CD19-positive B-cell monitoring compared to CD27-positive B-cell monitoring. The results indicated that the latter was safe and effective and associated with a relatively low frequency of RTX reinfusion. Only two relapses were recorded in the year before and after CD27-positive B-cell monitoring. However, the patients included in this cohort were found to be relatively stable.
Several limitations may influence the validity and applicability of the study findings. These include the study design (retrospective analysis) and the lack of relevant data on treatment response in the NMOSD and MOGAD participants.
The study concluded that CD27-positive B-cell monitoring of re-infusion of the RTX therapeutic regimen contributed to reducing the number of re-infusions. The treatment regimen has a comparable safety and efficacy profile.
Bruschi, N., Malentacchi, M., Malucchi, S., Sperli, F., Martire, S., Sala, A., Valentino, P., Bertolotto, A., Pautasso, M., & Capobianco, M. A. (2023). Tailoring Rituximab According to CD27-Positive B-Cell versus CD19-Positive B-Cell Monitoring in Neuromyelitis Optica Spectrum Disorder and MOG-Associated Disease: Results from a Single-Center Study. Neurol Ther. https://doi.org/10.1007/s40120-023-00481-w