Rituximab for the Treatment of Multiple Sclerosis: A Retrospective Observational Study of 50 Cases from Morocco, and Literature Review

¹Neurology Department, Military Hospital Avicenne, Marrakech, Morocco

²Neuroscience Research Laboratory, Marrakech Medical School, Cadi Ayyad University, Marrakesh, Morocco

*Corresponding Author: Prof. Oumerzouk Jawad, Professor of Neurology, University Hospitals in Marrakech, Marrakech, Postal Code: 40000, Morocco, Phone: 00(212)614134817, Emails: [email protected]; [email protected].

Received Date: February 20, 2024

Published Date: March 19, 2024

Citation: Jawad O, et al. (2024). Rituximab for the Treatment of Multiple Sclerosis: A Retrospective Observational Study of 50 Cases from Morocco, and Literature Review. Mathews J Case Rep. 9(3):160.

Copyrights: Jawad O, et al. © (2024).

ABSTRACT

Introduction : Rituximab (RTX) showed to be effective and relatively safe in the treatment of relapsing-remitting and progressive forms of multiple sclerosis (MS), both in the phase II setting and in some observational studies. Objective: To investigate the effectiveness and safety of rituximab in MS. Patients and methods: We report a retrospective observational study to describe the effectiveness and safety of off-label rituximab in the treatment of a population of Moroccan MS patients including 50 relapsing-remitting (RRMS) and progressive multiple sclerosis (PMS) subjects. Results: Our study showed that the RTX treatment was associated with the mean ARR decreasing by 0.72 at one year follow up. EDSS scores improved after 1 year of treatment with RTX by a score of 0.5-1.0 in 31 (62%) patients and remained stable in the second year of therapy. It should be emphasized that the mean reduction in EDSS was more significant in the RRMS subgroup compared to the PMS group (RRMS-25, SPMS-6, PPMS-0). EDSS score remained same in 12 patients (24%), of which 9 had RRMS and 3 SPMS. EDSS worsened after 2 years from RTX in 7 (14%) patients (5 SPMS, 2PPMS). Follow up MRI Brain with contrast at one year, show new T2 lesions in 6 patients (12%), with no enhancing lesions either old or new. Concerning safety issues in our patients, we observed a frequency of infusion associated reactions inferior to the data reported in other studies. Majority of patients (98%) tolerated RTX infusion well. Conclusion: RTX could be an effective and safe treatment in RRMS. Some selected PMS patients could also benefit from this treatment.

Keywords: Multiple Sclerosis, Rituximab, CD20.