Highlights
- •We described the therapeutic strategies in NMOSD and MOGAD in LATAM
- •8 countries and 14 LATAM centers were included (197 NMOSD and 20 MOGAD)
- •In NMOSD, most used RTX regimen was two 1gr infusions-15 days e/6 months (83.1%)
- •Relapses under RTX were observed in 21 (22.1%) NMOSD patients
- •Relapses were not associated with RTX regimen (OR1.195%CI 0.89-1.21p=0.60)
Abstract
Purpose
This study describes the therapeutic strategies in NMOSD and MOGAD adopted by neurologists
to treat both conditions in Latin America (LATAM) with main focus on rituximab (RTX)
and the disease outcome.
Methods
retrospective study in a cohort of NMOSD and MOGAD patients followed in specialized
MS/NMOSD centers from eight countries and 14 LATAM reference centers. Demographics
and clinical characteristics were collected. RTX strategies on naïve (for rituximab)
patients were summarized as follows: scheme A: two 1000 mg infusions 15 days apart
and repeated every 6 months; scheme B: four 375 mg/m2 infusions every week for 4 weeks
and repeated every 6 months; scheme C: one 1000 mg infusions and repeated every 6
months; scheme D: other scheme used. Relapse rate and adverse events during follow-up
were analyzed considering the different RTX schemes. Poisson and logistic regression
analysis were used to assess baseline aspects and disease activity during follow-up.
Results
A total of 217 patients were included. 197 were NMOSD patients (164, 83.2% AQP4-IgG
seropositive and 16.7% seronegative) and 20 were MOGAD patients. The most frequent
long-term treatment was RTX in both groups (48.2% and 65% for NMOSD and MOGAD patients,
respectively). The most common RTX regimen used in 79 (83.1%) patients was two 1000
mg infusions 15 days apart and repeat every 6 months. Relapses under RTX treatment
were observed in 21 (22.1%) patients. Relapses after RTX treatment were associated
with higher EDSS (OR 1.75, 95%CI 1.44-2.34, p = 0.03) and higher ARR pre-RTX (OR = 2.17, 95% CI 1.72-3.12, p = 0.002) but not with RTX regimen (OR = 1.10, 95% CI 0.89-1.21, p = 0.60).
Conclusion
the most strategy used in LATAM was RTX with two 1000 mg infusions 15 days apart.
Relapses during follow up were not associated with RTX regimen used.
Key words
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Article info
Publication history
Accepted:
January 5,
2023
Received in revised form:
December 23,
2022
Received:
August 3,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Elsevier B.V. All rights reserved.
