ArticleNeurology(R) neuroimmunology & neuroinflammation2024
Multiple Sclerosis, Rituximab, Hypogammaglobulinemia, and Risk of Infections.
Article in Neurology(R) neuroimmunology & neuroinflammation, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 1 of them a synthesis that pooled it.
What it found
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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
33 citing papers in PubMed, 1 synthesis or guideline pooled it, 62 citations in OpenAlex.
- Pooled it
- Impact of Anti-CD20 Therapies on Cytokine, Chemokine and Adhesion Molecule Dynamics in Multiple Sclerosis: A Narrative Review.Neurology and therapy · 2026Review
- Article
- Real-world experience with rituximab for multiple sclerosis treatment in a Brazilian tertiary center.Arquivos de neuro-psiquiatria · 2026Observational
- Real World Data of Laboratory Changes and Immunophenotyping in Patients with Multiple Sclerosis Treated with Ofatumumab-Single Center Experience.Biomedicines · 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
- 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
- Comparative Effectiveness of Rituximab Dosed Every 6 and 12 Months in Relapsing Multiple Sclerosis.Neurology · 2026Article
- Real-world comparison of anti-CD20 therapies: efficacy, infections, and immune profiles in a German cohort.Frontiers in immunology · 2026Article
- Comparative Safety Profiles of Ocrelizumab and Rituximab in Multiple Sclerosis Treatment Using Real-World Evidence.Annals of neurology · 2026Article
- CAR T cells as novel therapeutic strategy for multiple sclerosis and other neuroimmune disorders.Journal of neuroinflammation · 2025Review
- BAFF is a marker of hypogammaglobulinemia, neuroaxonal damage and inflammation in multiple sclerosis patients on ocrelizumab.Journal of neuroinflammation · 2025Article
- Article
- Epstein-Barr virus pathogenesis and emerging control strategies.Nature reviews. Microbiology · 2025Review
- 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 · 2025Article
- Ofatumumab treatment in patients with neuromyelitis optica spectrum disorder: a retrospective multicenter cohort study.Journal of neurology · 2025Article
- Advancing multiple sclerosis management in older adults.Nature reviews. Neurology · 2025Article
- West Nile Virus Neuroinvasive Disease in Patients Treated With Anti-CD20 Therapies.Neurology. Clinical practice · 2025Article
- Racial Inequities, Multiple Sclerosis, and Implementation of a Novel Treatment Algorithm at the Health System Level.Neurology · 2025Article
- De-escalating and discontinuing disease-modifying therapies in multiple sclerosis.Brain : a journal of neurology · 2025Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectivesB-cell-depleting therapies increase the risk of infections and hypogammaglobulinemia. These relationships are poorly understood. The objectives of these analyses were to estimate how much of this rituximab-associated infection risk is mediated by hypogammaglobulinemia and to identify other modifiable risk factors in persons with multiple sclerosis (pwMS).
methodsWe conducted a retrospective cohort study of rituximab-treated pwMS from January 1, 2008, to December 31, 2020, in Kaiser Permanente Southern California. Cumulative rituximab dose was defined as ≤2, >2 and ≤4, or >4 g. Serious infections were defined as infections requiring or prolonging hospitalizations, and recurrent outpatient infections as seeking care for ≥3 within 12 months. Exposures, outcomes, and covariates were collected from the electronic health record. Adjusted hazard ratios (aHRs) were estimated using Andersen-Gill hazards models, and generalized estimating equations were used to examine correlates of IgG values. Cross-sectional causal mediation analyses of rituximab and hypogammaglobulinemia were conducted.
resultsWe identified 2,482 pwMS who were treated with rituximab for a median of 2.4 years (interquartile range = 1.3-3.9). The average age at rituximab initiation was 43.0 years, 71.9% were female, 49.7% were White, non-Hispanic patients, and 29.6% had advanced disability (requiring walker or worse). Seven hundred patients (28.2%) developed recurrent outpatient infections, 155 (6.2%) developed serious infections, and only 248 (10.0%) had immunoglobulin G (IgG) < 700 mg/dL. Higher cumulative rituximab dose (>4 g) was correlated with lower IgG levels (Beta = -58.8, DISCUSSION: Higher cumulative rituximab doses increase the risk of infections even in this population where 90% of patients maintained normal IgG levels. Clinicians should strive to use minimally effective doses of rituximab and other B-cell-depleting therapies and consider important comorbidities to minimize risks of infections.
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What OpenQuestion holds
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.