Efficacy and safety of rituximab for relapsing-remitting multiple sclerosis: A systematic review and meta-analysis

Autoimmun Rev. 2019 May;18(5):542-548. doi: 10.1016/j.autrev.2019.03.011. Epub 2019 Mar 4.

Abstract

Objective: To evaluate the efficacy and safety of rituximab for relapsing-remitting multiple sclerosis.

Results: Fifteen studies that collectively included 946 patients were selected for the meta-analysis. Rituximab therapy was associated with the mean annualized relapse rates decreasing by 0.80 (95% confidence interval, 0.45-1.15) and the mean Expanded Disability Status Scale score decreasing by 0.46 (95% confidence interval, 0.05-0.87). The likelihood of patients experiencing a relapse after starting rituximab therapy was only 15% (95% confidence interval, 7%-26%). Although mild-to-moderate adverse events occurred in 29.6% of the patients, there were no severe adverse events.

Conclusions and relevance: This systematic review and meta-analysis shows that rituximab is associated with reduced annualized relapse rates and disability levels in patients with relapsing-remitting multiple sclerosis. It is also well tolerated and is not associated with serious adverse events.

Keywords: Efficacy; Relapsing-remitting multiple sclerosis; Rituximab; Safety.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Adult
  • Drug-Related Side Effects and Adverse Reactions / epidemiology
  • Female
  • Humans
  • Immunologic Factors / therapeutic use
  • Male
  • Multiple Sclerosis, Relapsing-Remitting / drug therapy*
  • Multiple Sclerosis, Relapsing-Remitting / epidemiology
  • Multiple Sclerosis, Relapsing-Remitting / pathology
  • Recurrence
  • Rituximab / therapeutic use*

Substances

  • Immunologic Factors
  • Rituximab