Author Of 1 Presentation
LB1215 - "Clinical course, Safety of Low-dose Rituximab for Vietnameses Patients with Neuromyelitis Optica Spectrum Disorder" (ID 2079)
Abstract
Background
Neuromyelitis Optica Spectrum Disorders (NMOSD) is a severe autoimmune disease, predominantly affects optic nerves and spinal cord. In Viet Nam, NMOSDs cases are rarely reported. The monoclonal anti-CD20 B-cell antibody Rituximab (RX) is the most effective off-label therapeutic option for NMOSD. For Vietnamese patients with NMOSD, RX is not covered by insurance; therefore, most patients can not afford the standard dose.
Objectives
To evaluate the clinical, MRI characteristics, disease impact; safety, efficiency of low-dose rituximab treatment in 8 Vietnamese patients.
Methods
We performed a prospective cohort study of 8 patients with NMOSD confirmed by presence of antibody Anti Aquaporine 4 (AQP4) IgG. All patients were infused with RX 100 mg once per week for 3 consecutive weeks, and infused three times at 4-week intervals from the last infusion at Ha Noi Medical University Hospital.
Results
8 patients with relapsing NMOSD were included, all patients were females with mean age at onset of 46 ( 26 to 64). At time of onset, long extensive myelitis transverse (LEMT) occured in 6/8. Optic neuritis occured in 1/8. Postrema syndrome revealed the diagnostic in 1/8. The mean annualised relapse rate was 1.18. Concomitant systemic lupus erythematous was found in 1/8 patients. The Expanded Disability Status Scale Score (EDSS) 3.0 and 6.0 was reached respectively 6/8 and 2/8 patients. Brain white matter lesions appeared in 3/8 subjects. Spinal cord MRI showed lesions extending across 3 or more segments in all 8/8 subjects. One or more CSF abnormalities were found at least once in 4/8 patients, pleocytosis in 4/8, oligoclonal bands were negative in all patient, high protein level in 3/8 patient. Low-dose Rituximab was well tolerated even after up to 5 consecutive treatment courses. None of 8 patients has had the new attack on treatment with low-dose Rituximab.
Conclusions
NMOSD has a poor prognosis in most cases. Compared with multiple sclerosis, NMOSD patients have a higher age at onset, females are more frequently affected and the course is more severe. Serum AQP4 antibody supports the probability of NMOSD. Low-dose Rituximab is effective in NMOSD and has an acceptable safety profile.
Presenter Of 1 Presentation
LB1215 - "Clinical course, Safety of Low-dose Rituximab for Vietnameses Patients with Neuromyelitis Optica Spectrum Disorder" (ID 2079)
Abstract
Background
Neuromyelitis Optica Spectrum Disorders (NMOSD) is a severe autoimmune disease, predominantly affects optic nerves and spinal cord. In Viet Nam, NMOSDs cases are rarely reported. The monoclonal anti-CD20 B-cell antibody Rituximab (RX) is the most effective off-label therapeutic option for NMOSD. For Vietnamese patients with NMOSD, RX is not covered by insurance; therefore, most patients can not afford the standard dose.
Objectives
To evaluate the clinical, MRI characteristics, disease impact; safety, efficiency of low-dose rituximab treatment in 8 Vietnamese patients.
Methods
We performed a prospective cohort study of 8 patients with NMOSD confirmed by presence of antibody Anti Aquaporine 4 (AQP4) IgG. All patients were infused with RX 100 mg once per week for 3 consecutive weeks, and infused three times at 4-week intervals from the last infusion at Ha Noi Medical University Hospital.
Results
8 patients with relapsing NMOSD were included, all patients were females with mean age at onset of 46 ( 26 to 64). At time of onset, long extensive myelitis transverse (LEMT) occured in 6/8. Optic neuritis occured in 1/8. Postrema syndrome revealed the diagnostic in 1/8. The mean annualised relapse rate was 1.18. Concomitant systemic lupus erythematous was found in 1/8 patients. The Expanded Disability Status Scale Score (EDSS) 3.0 and 6.0 was reached respectively 6/8 and 2/8 patients. Brain white matter lesions appeared in 3/8 subjects. Spinal cord MRI showed lesions extending across 3 or more segments in all 8/8 subjects. One or more CSF abnormalities were found at least once in 4/8 patients, pleocytosis in 4/8, oligoclonal bands were negative in all patient, high protein level in 3/8 patient. Low-dose Rituximab was well tolerated even after up to 5 consecutive treatment courses. None of 8 patients has had the new attack on treatment with low-dose Rituximab.
Conclusions
NMOSD has a poor prognosis in most cases. Compared with multiple sclerosis, NMOSD patients have a higher age at onset, females are more frequently affected and the course is more severe. Serum AQP4 antibody supports the probability of NMOSD. Low-dose Rituximab is effective in NMOSD and has an acceptable safety profile.