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Graves J, Vinayagasundaram U, Mowry EM, et al. Effects of rituximab on lymphocytes in multiple sclerosis and neuromyelitis optica. Mult Scler Relat Disord. 2013;3(2):244-52doi: 10.1016/j.msard.2013.10.003.
Graves, J., Vinayagasundaram, U., Mowry, E. M., Matthews, I. R., Marino, J. A., Cheng, J., & Waubant, E. (2014). Effects of rituximab on lymphocytes in multiple sclerosis and neuromyelitis optica. Multiple sclerosis and related disorders, 3(2), 244-52. https://doi.org/10.1016/j.msard.2013.10.003
Graves, Jennifer, et al. "Effects of rituximab on lymphocytes in multiple sclerosis and neuromyelitis optica." Multiple sclerosis and related disorders vol. 3,2 (2014): 244-52. doi: https://doi.org/10.1016/j.msard.2013.10.003
Graves J, Vinayagasundaram U, Mowry EM, Matthews IR, Marino JA, Cheng J, Waubant E. Effects of rituximab on lymphocytes in multiple sclerosis and neuromyelitis optica. Mult Scler Relat Disord. 2014 Mar;3(2):244-52. doi: 10.1016/j.msard.2013.10.003. Epub 2013 Oct 25. PMID: 25878012.
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Mult Scler Relat Disord. 2014 Mar;3(2):244-52. doi: 10.1016/j.msard.2013.10.003. Epub 2013 Oct 25.

Effects of rituximab on lymphocytes in multiple sclerosis and neuromyelitis optica.

Multiple sclerosis and related disorders

Jennifer Graves, Uma Vinayagasundaram, Ellen M Mowry, Ian R Matthews, Julia A Marino, Jing Cheng, Emmanuelle Waubant

Affiliations

  1. University of California, San Francisco, Department of Neurology, Box 3206, MS Center, 675 Nelson Rising Lane Suite 221, CA 94158, United States. Electronic address: [email protected].
  2. University of California, San Francisco, Department of Neurology, Box 3206, MS Center, 675 Nelson Rising Lane Suite 221, CA 94158, United States. Electronic address: [email protected].
  3. University of California, San Francisco, Department of Neurology, Box 3206, MS Center, 675 Nelson Rising Lane Suite 221, CA 94158, United States. Electronic address: [email protected].
  4. University of California, San Francisco, Department of Neurology, Box 3206, MS Center, 675 Nelson Rising Lane Suite 221, CA 94158, United States. Electronic address: [email protected].
  5. University of California, San Francisco, Department of Neurology, Box 3206, MS Center, 675 Nelson Rising Lane Suite 221, CA 94158, United States. Electronic address: [email protected].
  6. University of California, San Francisco, Department of Preventive & Restorative Dental Sciences, United States. Electronic address: [email protected].
  7. University of California, San Francisco, Department of Neurology, Box 3206, MS Center, 675 Nelson Rising Lane Suite 221, CA 94158, United States. Electronic address: [email protected].

PMID: 25878012 DOI: 10.1016/j.msard.2013.10.003

Abstract

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.

© 2013 Elsevier B.V. All rights reserved.

Keywords: Demyelinating diseases; Immunology; Monoclonal antibodies; Multiple sclerosis; Neuromyelitis optica; Rituximab

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