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Abstract Details

The Use of Rituximab in Neurological Diseases; Real World Data from a Neuroscience Centre
Autoimmune Neurology
P2 - Poster Session 2 (8:00 AM-9:00 AM)
15-008
To audit the use of Rituximab (RTX) in neurological diseases, after the establishment of a multidisciplinary team (MDT) panel
In the UK, the use of RTX for managing neuroinflammatory conditions is not regulated by guidelines and therefore remains unlicensed, restricting its availability. In 2017, at Imperial College Healthcare Trust an MDT panel, with peripheral nerve, epilepsy, neuroinflammatory experts and a neuropharmacist, was set up to establish appropriate indications for RTX and to ensure homogeneous administration
We collected data on patients treated with RTX from April 2018 to October 2019 and followed for 16.7 mean months
After the MDT panel inception, 8 patients were rejected, while 30 patients received RTX. Females predominated (63.3%; n=19) and the mean age at disease onset was 39.0 years (range=14-75). At first RTX dose, the mean age was 45.1 years (range=23-75) and the mean disease duration was 62.4 months (range=0-317). Most patients (60%; n=18) had previously failed other immunosuppressive therapies. The most common diagnoses were autoimmune encephalitis (36.7%; n=11), cerebral vasculitis (23.3%; n=7) and myasthenia (16.7%, n=5). Overall, 21 patients (70%) showed positive treatment response. The highest proportion of responders was observed, among patients with myasthenia (100%; strength improvement), autoimmune encephalitis (81.8%; reduced seizures frequency) and cerebral vasculitis (28.6%; no further stroke). We also successfully treated with RTX patients affected by Stiff-person syndrome (n=2), myopathy (n=1) CANOMAD (n=1), and Sjögren’s (n=1), although two patients, with CIDP and with relapsing central nervous system neuroinflammatory disorder, did not respond to the therapy. No severe side effects were recorded and only 15 (47%) patients experienced infusion reactions (13%; n=5) and infections (23%; n=10).

 

The introduction of the MDT panel allowed to safely and successfully deliver RTX, among patients with a range of neurological conditions. We propose the implementation of this model of care to ensure consistency of administration.

Authors/Disclosures

PRESENTER 		No disclosure on file
Paolo Muraro Paolo Muraro has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Cellerys. Paolo Muraro has received personal compensation in the range of $50,000-$99,999 for serving as an Expert Witness for Pinsent Masons LLP. Paolo Muraro has received personal compensation in the range of $50,000-$99,999 for serving as an Expert Witness for Taylor Wessing LLP. Paolo Muraro has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Bugge Valentin. Paolo Muraro has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Lambert Hornby LLP. The institution of Paolo Muraro has received research support from NIHR-EME. The institution of Paolo Muraro has received research support from Benaroya Research Institute.
Michael Johnson, PhD (Leeds General Infirmary) No disclosure on file
Victoria Sing-Curry No disclosure on file
No disclosure on file
Rachel Dorsey No disclosure on file
Richard S. Nicholas, FRCP (Imperial College Healthcare Trust) Dr. Nicholas has nothing to disclose.
Antonio Scalfari, MD Dr. Scalfari has nothing to disclose.