RT Journal Article
SR Electronic
T1 The use of rituximab in myasthenia gravis and Lambert–Eaton myasthenic syndrome
JF Journal of Neurology, Neurosurgery & Psychiatry
JO J Neurol Neurosurg Psychiatry
FD BMJ Publishing Group Ltd
SP 671
OP 673
DO 10.1136/jnnp.2009.197632
VO 82
IS 6
A1 Maddison, Paul
A1 McConville, John
A1 Farrugia, Maria Elena
A1 Davies, Nicholas
A1 Rose, Michael
A1 Norwood, Fiona
A1 Jungbluth, Heinz
A1 Robb, Stephanie
A1 Hilton-Jones, David
YR 2011
UL http://jnnp.bmj.com/content/82/6/671.abstract
AB Aim To assess the treatment effects of rituximab in a population of patients with myasthenia gravis and Lambert–Eaton myasthenic syndrome.Methods Data on all treated patients in the UK were collected from referring physicians, with full case ascertainment and follow-up.Results Since 2004, 10 patients with generalised myasthenia gravis (three of whom were positive for muscle-specific tyrosine kinase (MuSK) antibodies) and two patients with Lambert–Eaton myasthenic syndrome (LEMS) were treated with rituximab. Using the Myasthenia Gravis Foundation America postintervention status, three patients (25%) achieved remission, and a further five (42%) improved clinically over an 18-month period. Only one patient developed worsening symptoms. The probability of achieving remission was unrelated to the duration of neurological symptoms prior to treatment. All LEMS and MuSK antibody patients improved following rituximab treatment.Conclusion In a relatively large, unselected group of patients with myasthenia gravis and LEMS, rituximab treatment resulted in a significant clinical improvement in two-thirds of cases. As a selective, B cell targeted therapy, rituximab should be considered as a treatment option for patients with either myasthenia gravis or LEMS for whom standard immunosuppressive treatments have been unsuccessful.