Myasthénie grave résistante et rituximab : étude rétrospective monocentrique de 28 patients.

Rubrique ouverte à tous en lecture seule.
POUR ACCEDER AUX NOMBREUX AUTRES FORUMS IL EST NECESSAIRE DE S'INSCRIRE (fonction M'enregistrer en haut à droite de l'écran).
Répondre
Avatar du membre

Auteur du sujet
Pboulanger
Administrateur
Administrateur
Messages : 4897
Enregistré le : 02 févr. 2010 18:41
Localisation : La Chapelle en Serval F-60520
    Windows 10 Firefox
Genre :
Zodiaque : Lion
Âge : 61
Contact :
France

Myasthénie grave résistante et rituximab : étude rétrospective monocentrique de 28 patients.

Message par Pboulanger » 25 janv. 2017 10:03

:hi:

Lu sur https://www.ncbi.nlm.nih.gov/pubmed/28082209
Traduction disponible directement en cliquant en bas à droite de ce message sur notre forum

Image
Resistant myasthenia gravis and rituximab: A monocentric retrospective study of 28 patients.
Afanasiev V1, Demeret S2, Bolgert F2, Eymard B3, Laforêt P3, Benveniste O4.
Neuromuscul Disord. 2016 Dec 14. pii: S0960-8966(16)30300-5. doi: 10.1016/j.nmd.2016.12.004. [Epub ahead of print]


Abstract

This retrospective study evaluated the efficiency and tolerance of rituximab in the management of resistant myasthenia gravis (MG).

All patients who received rituximab for the treatment of MG between 2004 and 2015 at Pitié-Salpétrière University Hospital (Paris, France) were included.

The efficacy of rituximab was evaluated every 6 months by the myasthenic muscle score (MMS), the Myasthenia Gravis Foundation of America - Clinical Classification (MGFA-CC), the MGFA Therapy Status and the Postintervention Status (PIS).

All rituximab-related side effects were noted.

Twenty-eight patients were included:
  • 21 with anti-acetylcholine receptor antibodies,
  • 3 with anti-muscle-specific tyrosine kinase antibodies
  • 4 seronegatives.
The mean age at day 1 of RTX was 50.6 ± 12.0 years.

Patients previously received 1-4 immunosuppressants.
The mean follow-up was 27.2 months (range: 6-60 months).
The mean total dose of rituximab was 4.8 ± 2.5 g.
The initial median MMS (58.8 points) improved significantly at M6 (74.5 ± 15.0 points; p < 0.0001) and remained stable thereafter: at M12: 75.9 ± 14.0 points (p = 0.00014), at M36: 72.5 ± 13.1 points (p = 0.0013).

Among 16 patients with initial severe symptoms (MGFA-CC class IV), 14 improved.

The PIS showed efficacy in about 50% of patients: at M6, 12/28 (43%) patients were considered improved.

This benefit remained stable thereafter: at M12: 12/24, at M24: 7/17, at M36: 6/12. One patient developed a delayed progressive multifocal leukoencephalopathy.

Based on the PIS, rituximab may be efficient in 50% of patients with MG resistant to immunosuppressants.
Amicalement,
Image

Répondre

Retourner vers « Informations »