ArticleNeurology(R) neuroimmunology & neuroinflammation2022
Rituximab-Induced Hypogammaglobulinemia and Risk of Infection in Neuromyelitis Optica Spectrum Disorders: A 14-Year Real-Life Experience.
Article 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 24 papers, 1 of them a synthesis that pooled it.
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Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it, 38 citations in OpenAlex.
- Consensus Recommendations for the Diagnosis and Treatment of Neuromyelitis Optica Spectrum Disorders (NMOSD): The MENACTRIMS Guidelines.CNS drugs · 2026Guideline
- Optimizing the Use of Anti-CD20 Agents in Multiple Sclerosis and Other Autoimmune Central Nervous System Disorders: A Narrative Review.Neurology and therapy · 2026Review
- Safety and Effectiveness of Inebilizumab in Patients with Neuromyelitis Optica Spectrum Disorder: Interim Analysis of a Post-marketing Surveillance in Japan.Neurology and therapy · 2026Article
- Inebilizumab in AQP4-Seropositive NMOSD: One-Year Follow-Up From a Multicenter, Real-World Study.Annals of clinical and translational neurology · 2026Article
- Effectiveness and Safety of Inebilizumab for IgG4-Related Disease in a Real-World Clinical Setting in Japan: Protocol for a Long-Term Prospective Observational Study (4SigHT Study).Rheumatology and therapy · 2026Article
- Real World Data of Laboratory Changes and Immunophenotyping in Patients with Multiple Sclerosis Treated with Ofatumumab-Single Center Experience.Biomedicines · 2026Article
- Age, Low Immunoglobulin G, and M Serum Levels Predict Infections in People With AQP4-IgG+ NMOSD Treated With Rituximab-A Multicenter Cohort Study From the German Neuromyelitis Optica Study Group (NEMOS).European journal of neurology · 2026Article
- Astrocyte-derived extracellular vesicles as antigen-specific therapy for neuromyelitis optica spectrum disorder in the mouse model.bioRxiv : the preprint server for biology · 2025Article
- Switching from Rituximab to Eculizumab in US Patients with Neuromyelitis Optica Spectrum Disorder: Impact on Hospitalizations.Neurology and therapy · 2025Article
- Determinants of anti-HBs decline in rheumatoid arthritis patients undergoing rituximab therapy.Human vaccines & immunotherapeutics · 2025Article
- Incidence and Risk Factors for Serious Infections in Patients with Neuromyelitis Optica Spectrum Disorder: A Claims Database Study in Japan.Neurology and therapy · 2025Article
- Secondary hypogammaglobulinemia and lymphocytopenia in patients with inflammatory neurological diseases on anti-CD20 therapy: risk of infection and infection-related mortality.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025Article
- Long-Term Effectiveness and Safety of Rituximab in Neuromyelitis Optica Spectrum Disorder: A 5-Year Observational Study.CNS drugs · 2025Observational
- Relapse risk after rituximab discontinuation in neuromyelitis optica spectrum disorders: a multi-center retrospective cohort study.Journal of neurology · 2025Article
- Review
- Ten Years ofNeurology(R) neuroimmunology & neuroinflammation · 2025Article
- B cell depletion as a therapeutic strategy for neuromyelitis optica spectrum disorder: rationale, evidence, and challenges.Frontiers in immunology · 2025Review
- Hypogammaglobulinaemia during rituximab treatment in multiple sclerosis: A Swedish cohort study.European journal of neurology · 2024Article
- Relapses and Serious Infections in Patients with Neuromyelitis Optica Spectrum Disorder Treated with Rituximab: A Swedish Single-Center Study.Journal of clinical medicine · 2024Article
- Update on the diagnosis and treatment of neuromyelitis optica spectrum disorders (NMOSD) - revised recommendations of the Neuromyelitis Optica Study Group (NEMOS). Part II: Attack therapy and long-term management.Journal of neurology · 2024Review
Corrections and comments
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Authors and funding
5 authors at 1 institution in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectivesTo investigate the frequency and predictors of hypogammaglobulinemia during long-term rituximab (RTX) treatment in patients with neuromyelitis optica spectrum disorder (NMOSD) and its association with infections.
methodsWe retrospectively reviewed the data of patients with NMOSD who received RTX through the maintenance regimen based on memory B-cell detection for at least 1 year from 2006 to 2021 at an institutional referral center for NMOSD.
resultsA total of 169 patients received a median of 10 courses (range 1-27) of RTX reinfusion after induction over a median of 8 (range, 1-15) years. Their mean serum immunoglobulin (Ig)G level began to decline significantly after 2 years of treatment, steadily declined at a rate of 2%-8% per year for the following 8 years, and then plateaued after 10 years. The proportion of patients with hypo-IgG (<6 g/L) increased from 1.2% after 1 year of treatment to 41% after 14 years of treatment. While being treated with RTX, 58 (34%) patients had 114 infections, of whom 14 (8%) patients had 15 severe infections. Multivariable logistic regression analyses identified duration of RTX treatment in years (odds ratio [OR] 1.234, 95% confidence interval [CI] 1.015-1.502), mean annual RTX dose (OR 0.063, 95% CI 0.009-0.434), history of mitoxantrone (OR 3.318, 95% CI 1.109-9.93), hypo-IgG at baseline (OR 40.552, 95% CI 3.024-543.786), and body mass index >25 kg/m DISCUSSION: Over 14 years of long-term RTX treatment, IgG levels gradually decreased, and the frequency of hypo-IgG increased to 41% of the patients. Patients with prolonged memory B-cell depletion after RTX, previous mitoxantrone history, hypo-IgG at baseline, or obesity were at risk of developing RTX-induced hypogammaglobulinemia. Nevertheless, infection rates remained low during treatment, and reduced immunoglobulin levels were not associated with an increased incidence of infections.
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