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. 2016 May 25;3(7):552-5.
doi: 10.1002/acn3.314. eCollection 2016 Jul.

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

Dustin Anderson  1 , Cecile Phan  1 , Wendy S Johnston  1 , Zaeem A Siddiqi  1
Affiliations

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

Dustin Anderson et al. Ann Clin Transl Neurol. .

Abstract

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.

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Figures

Figure 1
Figure 1
Rituximab improves clinical characteristics in patients with refractory myasthenia gravis (MG). (A) Scatter plot of the effect of rituximab on MMT score in refractory MG patients treated with a single cycle of rituximab. (B) Plots demonstrating the time to peak response in these refractory patients. (C) Column plots showing the steroid sparing effect of rituximab. The frequency of IVIG infusions (D) and PLEX (E) are also reduced in patients treated with a single cycle of rituximab. Values are mean ± S.E.M. *P < 0.05. IVIG, intravenous immunoglobulin; MMT, manual muscle testing.
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