Evidence map›Paper›PMID 34815322›Full record

Observational studyNeurology(R) neuroimmunology & neuroinflammation2022

Hypogammaglobulinemia and Infections in Patients With Multiple Sclerosis Treated With Rituximab.

Marine Perriguey, Adil Maarouf, Jan-Patrick Stellmann, Audrey Rico, Clemence Boutiere, Sarah Demortiere, Pierre Durozard, Jean Pelletier, Bertrand Audoin

Open access · goldAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Neurology(R) neuroimmunology & neuroinflammation, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
36citing papers in PubMed, 3 pooled it
3.9field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

36 citing papers in PubMed, 3 syntheses or guidelines pooled it, 68 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Trial
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  6. Trial
  7. Article
  8. Article
  9. Article
  10. Prevalence of hypogammaglobulinemia after non-anti-CD20 therapies and impact of switching to rituximab/ocrelizumab in multiple sclerosis.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2025
    Article
  11. Article
  12. Review
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  14. Extended-interval dosing of rituximab/ocrelizumab is associated with a reduced decrease in IgG levels in multiple sclerosis.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2025
    Article
  15. Sequelae of B-Cell Depleting Therapy: An Immunologist's Perspective.BioDrugs : clinical immunotherapeutics, biopharmaceuticals and gene therapy · 2025
    Review
  16. Review
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  19. Multiple Sclerosis, Rituximab, Hypogammaglobulinemia, and Risk of Infections.Neurology(R) neuroimmunology & neuroinflammation · 2024
    Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 1 institution in 1 country.

Marine PerrigueyFrom the Aix Marseille University (M.P., A.M., A.R., C.B., S.D., P.D., J.P., B.A.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; Aix Marseille University (J.-P.S.), APHM, Hôpital de la Timone, Département de Neuroradiologie; Aix Marseille University (A.M., J.-P.S., A.R., C.B., S.D., P.D., J.P., B.A.), CRMBM UMR 7339, CNRS, Marseille, France.
Adil MaaroufFrom the Aix Marseille University (M.P., A.M., A.R., C.B., S.D., P.D., J.P., B.A.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; Aix Marseille University (J.-P.S.), APHM, Hôpital de la Timone, Département de Neuroradiologie; Aix Marseille University (A.M., J.-P.S., A.R., C.B., S.D., P.D., J.P., B.A.), CRMBM UMR 7339, CNRS, Marseille, France.
Jan-Patrick StellmannFrom the Aix Marseille University (M.P., A.M., A.R., C.B., S.D., P.D., J.P., B.A.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; Aix Marseille University (J.-P.S.), APHM, Hôpital de la Timone, Département de Neuroradiologie; Aix Marseille University (A.M., J.-P.S., A.R., C.B., S.D., P.D., J.P., B.A.), CRMBM UMR 7339, CNRS, Marseille, France.
Audrey RicoFrom the Aix Marseille University (M.P., A.M., A.R., C.B., S.D., P.D., J.P., B.A.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; Aix Marseille University (J.-P.S.), APHM, Hôpital de la Timone, Département de Neuroradiologie; Aix Marseille University (A.M., J.-P.S., A.R., C.B., S.D., P.D., J.P., B.A.), CRMBM UMR 7339, CNRS, Marseille, France.
Clemence BoutiereFrom the Aix Marseille University (M.P., A.M., A.R., C.B., S.D., P.D., J.P., B.A.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; Aix Marseille University (J.-P.S.), APHM, Hôpital de la Timone, Département de Neuroradiologie; Aix Marseille University (A.M., J.-P.S., A.R., C.B., S.D., P.D., J.P., B.A.), CRMBM UMR 7339, CNRS, Marseille, France.
Sarah DemortiereFrom the Aix Marseille University (M.P., A.M., A.R., C.B., S.D., P.D., J.P., B.A.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; Aix Marseille University (J.-P.S.), APHM, Hôpital de la Timone, Département de Neuroradiologie; Aix Marseille University (A.M., J.-P.S., A.R., C.B., S.D., P.D., J.P., B.A.), CRMBM UMR 7339, CNRS, Marseille, France.
Pierre DurozardFrom the Aix Marseille University (M.P., A.M., A.R., C.B., S.D., P.D., J.P., B.A.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; Aix Marseille University (J.-P.S.), APHM, Hôpital de la Timone, Département de Neuroradiologie; Aix Marseille University (A.M., J.-P.S., A.R., C.B., S.D., P.D., J.P., B.A.), CRMBM UMR 7339, CNRS, Marseille, France.
Jean PelletierFrom the Aix Marseille University (M.P., A.M., A.R., C.B., S.D., P.D., J.P., B.A.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; Aix Marseille University (J.-P.S.), APHM, Hôpital de la Timone, Département de Neuroradiologie; Aix Marseille University (A.M., J.-P.S., A.R., C.B., S.D., P.D., J.P., B.A.), CRMBM UMR 7339, CNRS, Marseille, France.
Bertrand AudoinFrom the Aix Marseille University (M.P., A.M., A.R., C.B., S.D., P.D., J.P., B.A.), APHM, Hôpital de la Timone, Pôle de Neurosciences Cliniques, Service de Neurologie; Aix Marseille University (J.-P.S.), APHM, Hôpital de la Timone, Département de Neuroradiologie; Aix Marseille University (A.M., J.-P.S., A.R., C.B., S.D., P.D., J.P., B.A.), CRMBM UMR 7339, CNRS, Marseille, France. bertrand.audoin@ap-hm.fr.ORCID 0000-0002-9860-7657
Centre National de la Recherche Scientifique · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectivesTo determine the frequency of hypogammaglobulinemia and infections in patients with multiple sclerosis (PwMS) receiving rituximab (RTX).

methodsThis prospective observational study included all consecutive PwMS receiving RTX at the university hospital of Marseille, France, between 2015 and 2020. Patient visits occurred at least every 6 months.

resultsWe included 188 patients (151 with relapsing-remitting MS; the mean age was 43.4 years [SD 12.9], median disease duration 10 years [range 0-36], median Expanded Disability Status Scale 5 [range 0-8], median follow-up 3.5 years [range 1-5.8], and median number of RTX infusions 5 [range 1-9]). Overall, 317 symptomatic infections and 13 severe infections occurred in 133 of 188 (70.7%) and 11 of 188 (5.9%) patients, respectively. After 4 years, 24.4% of patients (95% CI 18.0-33.1) were free of any infection and 92.0% (95% CI 87.1-97.1) had not experienced a severe infection. At RTX onset, the immunoglobulin G (IgG) level was abnormal in 32 of 188 (17%) patients. After RTX, IgG level was <7, <6, <4 and <2 g/L for 83 (44%), 44 (23.4%), 8 (4.2%) and 1 (0.53%) patients, respectively. The risk of infection was associated with reduced IgG levels (multivariate Cox proportional hazards hazard ratio [HR] = 0.86, 95% CI 0.75-0.98, DISCUSSION: In PwMS receiving RTX, reduced IgG level was frequent and interacted with the risk of infection.

Indexed as

AdultAgammaglobulinemiaFemaleHumansImmunologic FactorsInfectionsMaleMiddle AgedMultiple Sclerosis, Relapsing-RemittingProspective StudiesRituximabImmunologic FactorsRituximab

Identifiers

PMID34815322
PMCPMC8611503
OpenAlexW3215369393

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.