Myasthenia Gravis Support Group

Myasthenia gravis (MG) is a neuromuscular disease leading to fluctuating muscle weakness and fatiguability. The hallmark of myasthenia gravis is muscle weakness that increases during periods of activity and improves after periods of rest. Although myasthenia gravis may affect any voluntary muscle, muscles that control eye and eyelid movement, facial expression, and...

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Study: Early Rituximab promising for normal folks

Rhanson
Rhanson

https://www.medscape.com/viewarticle/930271  


Patients with myasthenia gravis (MG) who are treated early with the monoclonal antibody rituximab (multiple brands) achieve remission sooner than those treated later in the disease process, new research suggests.


Investigators compared patients with generalized MG who received rituximab within the first year of disease onset to those who received rituximab more than 1 year after disease onset and to a control group who received immunotherapy.


Results showed that time to median remission in the early-treatment group was 7 months, compared to 11 months in the conventional immunotherapy group and 16 months in the group with refractory disease.


"While these results have to be regarded as preliminary, they indicate that rituximab might be a promising therapy in MG," senior author Fredrik Piehl, MD, PhD, professor of neurology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden, told Medscape Medical News.


The actual research paper is at https://jamanetwork.com/journals/jamaneurology/article-abstract/2765474   


The treatment: 


Treatment with low-dose rituximab (most often 500 mg every 6 months) compared with conventional immunosuppressants.


The cost of a 500mg dose is approximately $50,000 in the USA, so $100,000 per year.  That is why it has been used primarily for refractory patients.   It came out in 1997 and so possibly with the 20 year patent on drugs in the US, a generic may be available. China has one underway.   http://www.gabionline.net/Biosimilars/News/Rituximab-copy-biological-accepted-for-review-in-China   


PeterL
PeterL
Russ. Thanks for that, I read the transcript yesterday, but note the limitations and the positives - it would be good for us older folk not needing the concoction of drugs we currently take (that's my reading of it) to get us to a stable state. Let;s hope this initial set of results moves on. Do you have access to the full report?

Thanks

Peter
Rhanson
Rhanson
I don't have access to the full article.

It is appealing to think about treatment every 6 months.
My brother took Rituxan as part of his treatment for leukemia about 12 years ago. The Rituxan part of the treatment had hardly any side effects compared to the rest of the cancer treatment.
The clinical trial has some details
https://www.clinicaltrials.gov/ct2/show/record/NCT02950155?term=NCT02950155&rank=1

Russ
Nanosecond
Nanosecond
Russ, thanks for posting this. I have generalized MG and although I am over three years into immunosuppressant treatment (prednisone and Imuran), I still have to take Mestinon 120mgs every four hours to control my symptoms. I have had a thymectomy. Plasmapheresis helps a lot, but my veins have become persnickety, and anyway now I am not having PLEX on account of the Covid-19 lockdown. Maybe my neurologist will be willing to try Rituxan on me, especially if it is relatively safe. Let's hope it goes generic!