Evidence map›Paper›PMID 40348903›Full record

ArticleJournal of neurology2025

Relapse risk after rituximab discontinuation in neuromyelitis optica spectrum disorders: a multi-center retrospective cohort study.

Shengfei Hu, Ziyu Liao, Rui Wang, Milan Zhang, Qiuming Zeng, Zhihua Zhao, Xi Wang, Hongyu Zhou, Wei Li, Yaxin Lu and 3 more

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Journal of neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

13 authors.

Shengfei Hu *Department of Neurology, Third Affiliated Hospital of Sun Yat-sen University, No. 600 Tianhe Road, Guangzhou, 510630, Guangdong Province, China.
Ziyu Liao *Department of Neurology, Third Affiliated Hospital of Sun Yat-sen University, No. 600 Tianhe Road, Guangzhou, 510630, Guangdong Province, China.
Rui Wang *Department of Neurology, West China Hospital of Sichuan University, Chengdu, China.
Milan Zhang *Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China.
Qiuming ZengDepartment of Neurology, Xiangya Hospital of Central South University, Changsha, China.
Zhihua ZhaoDepartment of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Xi WangDepartment of Neurology, Third Affiliated Hospital of Sun Yat-sen University, No. 600 Tianhe Road, Guangzhou, 510630, Guangdong Province, China.
Hongyu ZhouDepartment of Neurology, West China Hospital of Sichuan University, Chengdu, China.
Wei LiDepartment of Neurology, Henan Provincial People's Hospital, Zhengzhou, China.
Yaxin LuClinical Data Center, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Huan YangDepartment of Neurology, Xiangya Hospital of Central South University, Changsha, China.
Wei Qiu *Department of Neurology, Third Affiliated Hospital of Sun Yat-sen University, No. 600 Tianhe Road, Guangzhou, 510630, Guangdong Province, China. qiuwei@mail.sysu.edu.cn.
Rui Li *Department of Neurology, Third Affiliated Hospital of Sun Yat-sen University, No. 600 Tianhe Road, Guangzhou, 510630, Guangdong Province, China. lirui55@mail.sysu.edu.cn.ORCID http://orcid.org/0000-0002-1932-3737

Funding

the National Natural Science Foundation of China 81901229
6 · The paper itself

Abstract

objectiveWe aimed to evaluate the association between rituximab (RTX) treatment duration and relapse risk, and explore clinical outcomes following treatment discontinuation in neuromyelitis optica spectrum disorder (NMOSD).

methodsWe retrospectively collected data from rituximab-treated patients (>1-year follow-up after treatment initiation) with NMOSD at five major clinical centers in China between 2016 and 2023. The main outcome measures were changes in relapse risk based on the RTX treatment duration and clinical outcomes following relapse after RTX discontinuation. The Andersen-Gill model was used to analyze treatment duration-relapse risk associations.

resultsIn total, 106 rituximab-treated patients were included (40 patients discontinued and 66 continued RTX). Longer RTX treatment significantly reduced relapse risk (hazard ratio [HR]=0.43, P < 0.001). Among 28 patients who discontinued RTX and were followed-up for >1 year after drug withdrawal, 53.6% (15/28) relapsed at a median interval of 14 months. Patients with >2 years of RTX treatment exhibited lower annual relapse rate (ARR) (mean ARR: 0.97 vs. 0.28, P = 0.020) and less severe relapses (mean ΔEDSS score: 1.42 vs. 0.50, P = 0.021) after discontinuation, compared to pre-treatment levels. Only one of four (25%) longer-treated and clinically stable patients (≥2 years of RTX treatment and no relapses ≥2 years before discontinuation) experienced a non-severe relapse by 50 months. Patients aged >55 years in the discontinuation group had the lowest post-discontinuation relapse rate.

interpretationRTX treatment duration strongly correlated with reduced relapse risk in NMOSD patients. Relapse risk after RTX discontinuation was lower than that after discontinuing traditional oral immunosuppressants, particularly in patients with longer treatment and clinical stability.

Indexed as

Immunologic FactorsNeuromyelitis OpticaRituximabAdultChinaFemaleFollow-Up StudiesHumansMaleMiddle AgedRecurrenceRetrospective StudiesWithholding TreatmentYoung AdultImmunologic FactorsRituximabBiological productsDrug withdrawalNeuromyelitis opticaRelapse riskRituximab

Identifiers

PMID40348903

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.