TY - JOUR
T1 - Effects of rituximab on lymphocytes in multiple sclerosis and neuromyelitis optica
AU - Graves, Jennifer
AU - Vinayagasundaram, Uma
AU - Mowry, Ellen M.
AU - Matthews, Ian R.
AU - Marino, Julia A.
AU - Cheng, Jing
AU - Waubant, Emmanuelle
N1 - Funding Information:
The authors would like to acknowledge the National MS Society , the NIH , the Foundation for the Consortium of Multiple Sclerosis Centers and Nancy Davis Foundation for their support.
PY - 2014/3
Y1 - 2014/3
N2 - Objective To investigate the effect of rituximab, a B-cell targeted therapy that is used in the treatment of multiple sclerosis (MS) and neuromyelitis optica (NMO), on other immune cells such as CD4+ and CD8+ T-cells in patients with MS and NMO. Design, setting and patients This is a retrospective study of all patients with MS or NMO who received at least one rituximab infusion at the UCSF MS tertiary care center between May 2005 and July 2011. Main outcome measures Linear mixed models were used to assess (a) how post-infusion cell counts changed over time compared to pre-infusion levels and one another; (b) whether the cell counts were different over multiple courses of rituximab; and (c) what was the dosing effect on the cell counts over time. Results Rituximab initially reduced CD4+ (by 26%, p=0.0005) and CD8+ (by 22%, p=0.0006) T-cells, although these changes were only transient. Subsequent treatments with rituximab did not result in a significant drop in CD4+ or CD8+ T-cells. Changes in other cell types were also typically more marked after the first cycle of rituximab than after additional treatments. The total dose of rituximab received did not appear to have a significant effect. Conclusions Although transient, rituximab-induced decrease in CD4+ and CD8+ T-cells may increase the risk of infection in susceptible individuals.
AB - Objective To investigate the effect of rituximab, a B-cell targeted therapy that is used in the treatment of multiple sclerosis (MS) and neuromyelitis optica (NMO), on other immune cells such as CD4+ and CD8+ T-cells in patients with MS and NMO. Design, setting and patients This is a retrospective study of all patients with MS or NMO who received at least one rituximab infusion at the UCSF MS tertiary care center between May 2005 and July 2011. Main outcome measures Linear mixed models were used to assess (a) how post-infusion cell counts changed over time compared to pre-infusion levels and one another; (b) whether the cell counts were different over multiple courses of rituximab; and (c) what was the dosing effect on the cell counts over time. Results Rituximab initially reduced CD4+ (by 26%, p=0.0005) and CD8+ (by 22%, p=0.0006) T-cells, although these changes were only transient. Subsequent treatments with rituximab did not result in a significant drop in CD4+ or CD8+ T-cells. Changes in other cell types were also typically more marked after the first cycle of rituximab than after additional treatments. The total dose of rituximab received did not appear to have a significant effect. Conclusions Although transient, rituximab-induced decrease in CD4+ and CD8+ T-cells may increase the risk of infection in susceptible individuals.
KW - Demyelinating diseases
KW - Immunology
KW - Monoclonal antibodies
KW - Multiple sclerosis
KW - Neuromyelitis optica
KW - Rituximab
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U2 - 10.1016/j.msard.2013.10.003
DO - 10.1016/j.msard.2013.10.003
M3 - Article
C2 - 25878012
AN - SCOPUS:84892785246
SN - 2211-0348
VL - 3
SP - 244
EP - 252
JO - Multiple Sclerosis and Related Disorders
JF - Multiple Sclerosis and Related Disorders
IS - 2
ER -