The following is a summary of “Rituximab alone is as effective as associated with steroids on naive patients with generalized myasthenia gravis,” published in the June 2024 issue of Neurology by Héraud et al.

While Rituximab (RTX) shows promise for treating severe myasthenia gravis (MG), minimizing long-term corticosteroid (CS) use remains crucial for managing the disease.

Researchers conducted a retrospective study to compare the effectiveness of RTX with and without CS in achieving remission for MG.

They conducted a cohort study at Nice University Hospital, comparing treatment-naive MG patients who received RTX alone (Group 1) or in combination with CS (Group 2). Following RTX induction, efficacy was assessed using the Osserman score (OS) and the need for rescue therapy (IVIg or plasmapheresis).

The results showed that of 68 patients treated with RTX, 19 (27.94%) received a combination with at least 0.5 mg/kg of corticosteroids. Patients receiving RTX-CS had more severe conditions than those receiving RTX alone (OS: G1 = 74.1, G2 = 64.94, P=0.044). However, OS at 3 (83.44 and 83.12, P=0.993), 6 (88.69 and 86.36, P=0.545), 9 (82.91 and 85.73, P=0.563), and 12 months (86.6 and 88.69, P=0.761) from treatment initiation were comparable. The need for rescue therapy post-RTX induction was significantly higher for RTX-CS (20.41% and 47.37%, P=0.037). The AE  rates were similar between the two groups (0% and 14.29%, P=0.178).

Investigators concluded that RTX monotherapy achieved similar outcomes to RTX combined with CS in patients with MG, suggesting potential benefits for reducing side effects, medication use, and maintaining positive MG outcomes.

Source: link.springer.com/article/10.1007/s00415-024-12454-6