ArticleJournal of clinical neurology (Seoul, Korea)2025
Evaluating Rituximab Failure Rates in Neuromyelitis Optica Spectrum Disorder: A Nationwide Real-World Study From South Korea.
Article in Journal of clinical neurology (Seoul, Korea), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Real-World Investigation of Satralizumab in Patients With Neuromyelitis Optica Spectrum Disease.Annals of clinical and translational neurology · 2026Article
- Neuromyelitis optica spectrum disorder overlapping with Sjögren's disease: immunopathological links and therapeutic implications.Frontiers in immunology · 2026Review
- Subsequent treatment strategies following rituximab-resistance in AQP4-IgG+ neuromyelitis optica spectrum disorder: a case series.Frontiers in immunology · 2026Article
- Distinct remission immune architectures under rituximab and azathioprine in AQP4-IgG-positive neuromyelitis optica spectrum disorder.Frontiers in immunology · 2026Article
- Severe attacks and worse prognosis in patients with late-onset neuromyelitis optica spectrum disorder highlight the need for early highly effective treatment.Journal of neurology · 2025Article
- B cell receptor repertoire reconstitution in patients with neuromyelitis optica spectrum disorder receiving B-cell depletion therapy.Frontiers in immunology · 2025Article
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Authors and funding
36 authors.
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Abstract
background and purposeTreatments for neuromyelitis optica spectrum disorder (NMOSD) such as eculizumab, ravulizumab, satralizumab, and inebilizumab have significantly advanced relapse prevention, but they remain expensive. Rituximab is an off-label yet popular alternative that offers a cost-effective solution, but its real-world efficacy needs better quantification for guiding the application of newer approved NMOSD treatments (ANTs). This study aimed to determine real-world rituximab failure rates to anticipate the demand for ANTs and aid in resource allocation.
methodsWe conducted a nationwide retrospective study involving 605 aquaporin-4-antibody-positive NMOSD patients from 22 centers in South Korea that assessed the efficacy and safety of rituximab over a median follow-up of 47 months.
resultsThe 605 patients treated with rituximab included 525 (87%) who received continuous therapy throughout the follow-up period (median=47 months, interquartile range=15-87 months). During this period, 117 patients (19%) experienced at least 1 relapse. Notably, 68 of these patients (11% of the total cohort) experienced multiple relapses or at least 1 severe relapse. Additionally, 2% of the patients discontinued rituximab due to adverse events, which included severe infusion reactions, neutropenia, and infections.
conclusionsThis study has confirmed the efficacy of rituximab in treating NMOSD, as evidenced by an 87% continuation rate among patients over a 4-year follow-up period. Nevertheless, the occurrence of at least one relapse in 19% of the cohort, including 11% who experienced multiple or severe relapses, and a 2% discontinuation rate due to adverse events highlight the urgent need for alternative therapeutic options.
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