Document Type : Original Article


1 Neurology Research Center, Kerman University of Medical Sciences, Kerman, Iran Department of Neurology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran

2 Immunogenetics Research Center, Mazandaran University of Medical Sciences, Sari, Iran Department of Neurology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran Neuromuscular Research Center, Tehran University of Medical Sciences, Tehran, Iran

3 Department of Neurology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran Neuromuscular Research Center, Tehran University of Medical Sciences, Tehran, Iran

4 Department of Neurology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran Neuromuscular Research Center, Tehran University of Medical Sciences, Tehran, Iran Department of Neurology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran


Background: This retrospective cohort study was conducted to evaluate the efficacy and tolerance of rituximab (RTX) for the management of myasthenia gravis (MG).
Methods: This retrospective cross-sectional study was conducted on 61 patients with refractory and non-refractory MG who received RTX. The Myasthenia Gravis Activities of Daily Living (MG-ADL) profile was used to assess MG symptoms and their effects on daily activities at the start of RTX and in the last follow-up. The Myasthenia Gravis Foundation of America Post-Intervention Status (MGFA-PIS) scale has been used as an outcome measure after treatment with RTX in the 12th month and the last follow-up.
Results: The mean age of the patients was 40.31 ± 13.53 years (range: 15-78 years). Of 61 patients, eight (13.1%) were double seronegative, 29 (47.5%) had anti-acetylcholine receptor (AChR+) antibody, and 24 (39.3%) had anti-muscle-specific tyrosine kinase antibody (MuSK+). According to the mean rank table, the results of this study showed that the drug was more effective in improving the symptoms of MuSK+ patients compared to the other two groups (P = 0.006). The mean MG-ADL was 4.86 ± 1.83 before treatment and 1.51 ± 2.02 in the last follow-up visit. Paired t-test showed a significant association between MG-ADL before and after treatment in the last visit [t(55): 11.30, 95% confidence interval (CI): 2.79-3.99, P = 0.001)].
Conclusion: This retrospective study showed a considerable effect of RTX as induction therapy in patients with MG, especially those with MuSk+ MG.


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