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Abstract Details

Rituximab in refractory myasthenia gravis: experience in a single healthcare center in Mexico.
Neuromuscular and Clinical Neurophysiology (EMG)
Neuromuscular and Clinical Neurophysiology (EMG) Posters (7:00 AM-5:00 PM)
103
Describe treatment response with Rituximab therapy in Mexican patients with refractory myasthenia gravis.

An estimated 10-15% of patients with Myasthenia gravis (MG) have treatment-refractory disease. In short series and case reports, Rituximab has shown efficacy in treating refractory MG. There are only case reports of patients treated with Rituximab in Mexico. 
A retrospective, longitudinal study was conducted. Recruitment was performed in a MG cohort from a single third level healthcare center in Mexico. Selection included refractory MG that were treated with Rituximab. We evaluated response after Rituximab therapy with Myasthenia Gravis Composite Score (MGCS) and prednisone dose reduction at 6, 12 and 18 months after initial therapy. Wilcoxon signed-rank test was used to evaluate differences between related groups for non-continual variables. P<0.05 was considered statistically significant.

Ten patients (7%) fulfilled criteria for refractory myasthenia gravis, and eight of them were treated with Rituximab. The mean age at MG diagnosis was 25.5 (±2) years, with a female predominance (75%). One hundred percent of our patients had positive AchR antibodies. The median MG duration was 6 years (IQR 4.2-6) before RITUXIMAB initiation. Before Rituximab therapy, all patients were previously treated with azathioprine and 50% additionally with cyclophosphamide. The median prednisone doses before Rituximab treatment and 18-month follow-up were 50 mg (IQR 30-50 mg) and 10 mg (IQR 0-20 mg) respectively (p=0.011).  The median baseline MGCS and 18-month follow-up were 19.5 (IQR 11-31) and 6 (IQR0-16) respectively (p 0.012).

Rituximab appears safe and effective for the treatment of refractory MG with positive AchR antibodies.
Authors/Disclosures
Javier A. Galnares-Olalde, Jr., MD (Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez)
PRESENTER 		Dr. Galnares-Olalde has nothing to disclose.
No disclosure on file
Enrique Gomez Figueroa, MD, MSc Dr. Gomez Figueroa has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen Mexico. Dr. Gomez Figueroa has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Astra Zeneca Mexico. Dr. Gomez Figueroa has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Johnson & Johnson LATAM.
Adib Jorge De Sarachaga, MD (Instituto Nacional De Neurologia Y Neurocirugia Manuel Velasco Suarez) Dr. Jorge De Sarachaga has nothing to disclose.
Edwin S. Vargas, MD (National Institute of Neurology, Mexico) Dr. Vargas has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Sanofi. Dr. Vargas has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for CSL Berhing.