The following article is part of conference coverage from the 2019 American Academy of Neurology Annual Meeting (AAN 2019) in Philadelphia, PA. Neurology Advisor’s staff will be reporting breaking news associated with research conducted by leading experts in neurology. Check back for the latest news from AAN 2019.
PHILADELPHIA — Serious infections related to treatment with rituximab in patients with multiple sclerosis (MS) are rare and successfully resolvable, according to study results presented at the 2019 American Academy of Neurology Annual Meeting held May 4-10 in Philadelphia, Pennsylvania.
Large real-world cohorts of patients with MS treated with anti-CD20 medications studying the long-term safety data of such treatment are limited. Studies of therapies, such as ocrelizumab have demonstrated a possible increased risk for developing sepsis and pneumonia in patients with MS receiving this treatment. Other effective therapies for MS are complicated by serious infections with herpes-family viruses or by progressive multifocal leukoencephalopathy.
Therefore, researchers identified 1450 patients with MS or neuromyelitis optica receiving treatment with rituximab from electronic health records of individuals hospitalized at Kaiser Permanente Southern California between 2008 and mid-2018 to evaluate the effect and relationship between rituximab treatment and the development of a serious infection. In addition, researchers identified a subset cohort of patients from the Swedish MS register.
The study found that 85 patients (5.9%) were hospitalized 180 times as a result of serious infections after initiation of rituximab; researchers attribute 91.8% of these hospitalizations to advanced MS. In contrast, they reported that infections were related to treatment with rituximab in 0.9% of patients (n=13) in the cohort, all of whom recovered completely. The crude rate for rituximab-related serious infection was 4.16 per 1000 person-years. There were no cases of progressive multifocal leukoencephalopathy or serious infections due to herpesviridae pathogens.
Researchers concluded that “rituximab-related serious infections are rare and this far all [patients] have fully recovered…[and] whether rituximab increases the risk of advanced MS-related infections is unclear.”
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Langer-Gould A, Smith J, Piehl F, Li B, Frisell T. Serious infections in two large US and Swedish rituximab-treated multiple sclerosis cohorts. Presented at: 2019 American Academy of Neurology Annual Meeting, May 4-10, Philadelphia, Pennsylvania.