Observational studyNeurology(R) neuroimmunology & neuroinflammation2023
Efficacy of Rituximab Outlasts B-Cell Repopulation in Multiple Sclerosis: Time to Rethink Dosing?
Observational study in Neurology(R) neuroimmunology & neuroinflammation, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled 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.
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.
Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Rituximab for people with multiple sclerosis.The Cochrane database of systematic reviews · 2025Pooled it
- Optimizing the Use of Anti-CD20 Agents in Multiple Sclerosis and Other Autoimmune Central Nervous System Disorders: A Narrative Review.Neurology and therapy · 2026Review
- Anti-CD20 Discontinuation Versus Continuation in People Aged Over 50 With Non-Active Multiple Sclerosis.Annals of clinical and translational neurology · 2026Article
- Review
- Impact of Anti-CD20 Therapies on Cytokine, Chemokine and Adhesion Molecule Dynamics in Multiple Sclerosis: A Narrative Review.Neurology and therapy · 2026Review
- The Treatment of Antibody-Mediated Encephalitis: Current, Future Therapies, Unmet Need and Patient Management.Advances in therapy · 2026Review
- Optimizing Rituximab Maintenance Therapy: Outcomes of Extended-Interval Dosing in Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorder.Journal of clinical medicine research · 2026Article
- The real-world effectiveness and safety of off-label rituximab in a large cohort of Middle Eastern multiple sclerosis patients.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2026Observational
- Comparative Effectiveness of Rituximab Dosed Every 6 and 12 Months in Relapsing Multiple Sclerosis.Neurology · 2026Article
- Effectiveness of Rituximab in rElapsiNg Multiple SclErosis previously treated with hiGhly-Active Disease modifying thErapies (RENEGADE study).Journal of neurology · 2025Observational
- Durable B-Cell Impairment While Sparing IgA B Cells After Ocrelizumab Therapy in Multiple Sclerosis.Annals of clinical and translational neurology · 2025Article
- The Present and Future of Monoclonal Antibody Therapies for Multiple Sclerosis.BioDrugs : clinical immunotherapeutics, biopharmaceuticals and gene therapy · 2025Review
- Comparative Effect of Standard Versus Extended Interval Dosing of Rituximab or Ocrelizumab in Multiple Sclerosis.Annals of clinical and translational neurology · 2025Article
- The Evolution of Anti-CD20 Treatment for Multiple Sclerosis: Optimization of Antibody Characteristics and Function.CNS drugs · 2025Review
- De-escalating and discontinuing disease-modifying therapies in multiple sclerosis.Brain : a journal of neurology · 2025Review
- 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 · 2025Article
- Optimizing Drug Selection in Children with Multiple Sclerosis: What Do We Know and What Remains Unanswered?Paediatric drugs · 2025Review
- B-cell Depletion Therapy in Pediatric Neuroinflammatory Disease.Current neurology and neuroscience reports · 2024Review
- De-escalation and Discontinuation of Disease-Modifying Therapies in Multiple Sclerosis.Current neurology and neuroscience reports · 2024Review
- Effect of Prior Treatment With Fingolimod on Early and Late Response to Rituximab/Ocrelizumab in Patients With Multiple Sclerosis.Neurology(R) neuroimmunology & neuroinflammation · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectivesPatients with multiple sclerosis (PwMS) receiving extended dosing of rituximab (RTX) have exhibited no return of disease activity, which suggests that maintenance of deep depletion of circulating B cells is not necessary to maintain the efficacy of RTX in MS.
methodsThis was a prospective monocentric observational study including all consecutive PwMS who started or continued RTX after 2019, when the medical staff decided to extend the dosing interval up to 24 months for all patients. Circulating B-cell subsets were monitored regularly and systematically in case of relapse. The first extended interval was analyzed.
resultsWe included 236 PwMS (81% with relapsing-remitting MS; mean [SD] age 43 [12] years; median [range] EDSS score 4 [0-8]; mean relapse rate during the year before RTX start 1.09 [0.99]; 41.5% with MRI activity). The median number of RTX infusions before extension was 4 (1-13). At the time of the analysis, the median delay in dosing was 17 months (8-39); the median proportion of circulating CD19 DISCUSSION: The efficacy of RTX outlasted substantial reconstitution of circulating B cells in PwMS, which suggests that renewal of the immune system underlies the prolonged effect of RTX in MS. These findings suggest that extended interval dosing of RTX that leads to a significant reconstitution of circulating B cells is safe in PwMS, could reduce the risk of infection, and could improve vaccine efficacy.
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Registered trials
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.