Treatment of multiple sclerosis with rituximab: A multicentric Italian–Swiss experience

Posted on 02.10.2019 - 12:08

Rituximab, an anti-CD20 monoclonal antibody leading to B lymphocyte depletion, is increasingly used as an off-label treatment option for multiple sclerosis (MS).


To investigate the effectiveness and safety of rituximab in relapsing–remitting (RR) and progressive MS.


This is a multicenter, retrospective study on consecutive MS patients treated off-label with rituximab in 22 Italian and 1 Swiss MS centers. Relapse rate, time to first relapse, Expanded Disability Status Scale (EDSS) progression, incidence of adverse events, and radiological outcomes from 2009 to 2019 were analyzed.


A total of 355/451 enrolled subjects had at least one follow-up visit and were included in the outcome analysis. Annualized relapse rate significantly decreases after rituximab initiation versus the pre-rituximab start year in RRMS (from 0.86 to 0.09, p < .0001) and in secondary-progressive (SP) MS (from 0.34 to 0.06, p < .0001) and had a slight decrease in primary-progressive (PP) MS patients (from 0.12 to 0.07, p = 0.45). After 3 years from rituximab start, the proportion of patients with a confirmed EDSS progression was 14.6% in the RRMS group, 24.7% in the SPMS group, and 41.5% in the PPMS group. No major safety concerns arose.


Consistently with other observational studies, our data show effectiveness of rituximab in reducing disease activity in patients with MS.


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Zecca, Chiara; Bovis, Francesca; Novi, Giovanni; Capobianco, Marco; Lanzillo, Roberta; Frau, Jessica; et al. (2019): Treatment of multiple sclerosis with rituximab: A multicentric Italian–Swiss experience. SAGE Journals. Collection.


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Chiara Zecca
Francesca Bovis
Giovanni Novi
Marco Capobianco
Roberta Lanzillo
Jessica Frau
Anna Maria Repice
Bahia Hakiki
Sabrina Realmuto
Simona Bonavita
Erica Curti
Laura Brambilla
Giorgia Mataluni
Paola Cavalla
Alessia Di Sapio
Elisabetta Signoriello
Stefania Barone
Giorgia T Maniscalco
Ilaria Maietta
Isabella Maraffi
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