Long-Term Clinical Outcomes of Rituximab Across Serological Subtypes of Myasthenia Gravis

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Uludağ Üniversitesi Tıp Fakültesi Dergisi
Cilt: 51 Sayı: 3
Long-Term Clinical Outcomes of Rituximab Across Serological Subtypes of Myasthenia Gravis

Long-Term Clinical Outcomes of Rituximab Across Serological Subtypes of Myasthenia Gravis

Authors : Emel Oğuz-Akarsu, Nida Meriç Koyuncu Yilmaz, Sarra Elhamida Lazrak, Yasemin Dinç, Necdet Karlı

Pages : 559-564

Doi:10.32708/uutfd.1796880

View : 64 | Download : 325

Publication Date : 2025-12-08

Article Type : Research Paper

Abstract :Rituximab, a B-cell-depleting monoclonal antibody, has gained increasing attention as a therapeutic option for myasthenia gravis (MG), particularly in refractory cases. However, its long-term efficacy across different serological subtypes remains to be investigated. This study aimed to evaluate the long-term clinical outcomes of rituximab treatment in patients with generalized myasthenia gravis (MG), including those with anti-acetylcholine receptor (AChR) antibodies, anti-muscle-specific kinase (MuSK) antibodies, and double-seronegative profiles. A retrospective cross-sectional study was conducted at the Neuromuscular Unit between 2012 and 2024. Thirty-six patients who received rituximab and had a minimum follow-up of 12 months were included. Treatment outcomes were assessed using MGFA and MGFA-PIS scores at baseline, at 6 months, and at the final evaluation. Subgroup analyses were performed based on antibody status. Sustained clinical improvement was observed in all serological subgroups. At six months, 70% of patients showed improvement or remission according to MGFA-PIS, increasing to 100% at final evaluation. AChR+ and MuSK+ patients demonstrated early and persistent responses, while a delayed but significant benefit was seen in double-seronegative patients. Rituximab appears to be a safe and effective long-term treatment for generalized MG, with benefits observed across all major antibody subtypes. The lack of a significant difference between the 6-month and final follow-up in AChR+ and MuSK+ patients suggests that the early improvement was sustained in the long term.
Keywords : Miyastenia Gravis, rituksimab, anti–asetilkolin reseptörü antikoru, anti–kas-spesifik kinaz antikoru, seronegatif

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