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Utilizing social networks can improve efficacy and safety outcomes in low-dose rituximab therapy for central nervous system demyelinating diseases, according to a recent study.

The impact of social media extends into the domains of healthcare and medical research. The complex nature of central nervous system (CNS) demyelinating diseases requires ongoing research, careful treatment monitoring, and insight-sharing between healthcare providers and patients. 

A study in the Interdisciplinary Journal of Virtual Learning in Medical Sciences examined the impact of social networks on enhancing safety and efficacy outcomes in low-dose rituximab treatment for CNS demyelinating diseases.

Study Population

A total of 99 patients were enrolled. These included 42 patients with relapsing–remitting multiple sclerosis (RMMS), 43 with secondary progressive multiple sclerosis (SPMS), and 14 with neuromyelitis optica spectrum disorder (NMOSD). The mean age was 39.5 years, and 67.7% of the patients were female. No significant demographic differences were observed among the groups.

Skype and WhatsApp Were Used for Virtual Patient Care

Participants were added to virtual Skype groups for education regarding low-dose rituximab treatment and follow-up by neurologists and nursing staff specializing in CNS demyelinating diseases. Patients were also added to WhatsApp groups for peer support and question–answer sessions.

Low-Dose Rituximab Improved Quality of Life and Disease Control

The mean follow-up for rituximab therapy was 20.4 months. The number of clinical attacks during treatment was 8 (19%), 10 (23.2%), and 1 (7%) among patients with RRMS, SPMS, and NMOSD, respectively. Of the 19 patients who experienced attacks during follow-up, 13 experienced one episode, 4 had two, and 2 experienced three episodes. With low-dose rituximab, 80.8% of patients achieved complete disease control without relapses, whereas all had previously encountered treatment failure with other medications. 

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The last Expanded Disability Status Scale (EDSS) score was subtracted from the baseline EDSS score for each patient. A decrease in the mean EDSS variability was observed in RRMS (−0.32, p=0.06) and NMOSD (−0.57, p=0.004) patients, while a slight increase was noted in SPMS (+0.19, p=0.23) patients. The follow-up magnetic resonance imaging (MRI) revealed new lesions on T2-weighted and gadolinium-enhanced images in nine and four patients, respectively. Serum IgG levels declined in 13.9% and 10% of SPMS and NMOSD patients, respectively. There were no cases of opportunistic infection in patients with low serum IgG.

Remarkably Low Incidence of Adverse Effects in Rituximab Treatment

Out of the 818 administered rituximab doses, there were only two adverse effect cases. The reported adverse effects were flushing and thrombocytopenia in SPMS patients during and after infusion, respectively. In the case of flushing, there were no hives, shortness of breath, or hemodynamic changes, and the patient completed the dose at a reduced infusion rate without any further complications. In the second case, the platelet count was 11.5×109/L after the fourth rituximab course but spontaneously returned to normal during the next four months.

In conclusion, these findings highlight the importance of social networks in improving the patient’s treatment journey and overall well-being regarding rituximab therapy for CNS demyelinating diseases.


Nabiuni, M., Mokhtari, M., Hatam, J., Emamikhah, M., Abolmaali, M., Amini, E., Saiyarsarai, P., Moghaddasi, M., Milanifard, M., Nabiuni, S., & Nabiuni, H. (2023). The Impact of Social Networks on Enhancing Safety and Efficacy Outcomes in Low-Dose Rituximab Treatment for Central Nervous System Demyelinating Diseases. Interdisciplinary Journal of Virtual Learning in Medical Sciences, 14(3), 206-215. https://doi.org/10.30476/ijvlms.2023.99354.1240