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dc.contributor.authorBlum, Stefan
dc.contributor.authorGillis, David
dc.contributor.authorBrown, Helen
dc.contributor.authorBoyle, Richard
dc.contributor.authorHenderson, Robert
dc.contributor.authorHeyworth-Smith, David
dc.contributor.authorHogan, Patrick
dc.contributor.authorKubler, Paul
dc.contributor.authorLander, Cecilie
dc.contributor.authorLimberg, Nicole
dc.contributor.authorPillans, Peter
dc.contributor.authorPrain, Kerri
dc.contributor.authorStaples, Christopher
dc.contributor.authorWalsh, Michael
dc.contributor.authorMcCombe, Pamela
dc.contributor.authorWong, Richard
dc.date.accessioned2017-05-03T14:19:23Z
dc.date.available2017-05-03T14:19:23Z
dc.date.issued2011
dc.date.modified2014-08-28T05:06:03Z
dc.identifier.issn0022-3050
dc.identifier.doi10.1136/jnnp.2010.220475
dc.identifier.urihttp://hdl.handle.net/10072/38259
dc.description.abstractBackground Myasthenia gravis is an autoimmune disorder of the neuromuscular junction. Rituximab (RTX), a monoclonal antibody to CD20, leads to B lymphocyte depletion and has been used in some autoimmune disorders, including small case series of myasthenia gravis patients. Methods A retrospective analysis was performed of all patients with acetylcholine receptor (AChR) (11 subjects) or muscle specific kinase antibody (MuSK) positive myasthenia gravis (three subjects), who had been treated with RTX in Brisbane, Australia. In most patients 1 g of RTX, in two divided doses, was given. Patients were monitored by serial clinical assessments, flow cytometry of peripheral blood B lymphocytes and antibody testing. Results RTX led to a significant improvement in symptoms in 11 of 14 patients. Doses of immunosuppressive medications were able to be reduced in 12 of 14 patients but medications could be completely ceased in only one patient. A demonstrable reduction of autoantibody levels was found in only three AChR positive patients and one MuSK positive patient, independent of clinical improvement. Peripheral blood B lymphocyte depletion was achieved in 13 out of 14 patients. B lymphocyte recovery occurred between 9 and 30 months post RTX (median 12.3 months) and was consistently associated with worsening of clinical symptoms. Conclusion Rituximab at a dose of 1 g appears to be beneficial in the treatment of patients with severe myasthenia gravis. Serial monitoring of peripheral blood B lymphocytes appears to be useful in guiding the need for further RTX therapy.
dc.description.peerreviewedYes
dc.description.publicationstatusYes
dc.languageEnglish
dc.language.isoeng
dc.publisherBMJ Group
dc.publisher.placeUnited Kingdom
dc.relation.ispartofstudentpublicationN
dc.relation.ispartofpagefrom659
dc.relation.ispartofpageto663
dc.relation.ispartofissue82
dc.relation.ispartofjournalJournal of Neurology, Neurosurgery and Psychiatry
dc.relation.ispartofvolume2011
dc.rights.retentionY
dc.subject.fieldofresearchMedical and Health Sciences not elsewhere classified
dc.subject.fieldofresearchMedical and Health Sciences
dc.subject.fieldofresearchPsychology and Cognitive Sciences
dc.subject.fieldofresearchcode119999
dc.subject.fieldofresearchcode11
dc.subject.fieldofresearchcode17
dc.titleUse and monitoring of low dose rituximab in myasthenia gravis
dc.typeJournal article
dc.type.descriptionC1 - Articles
dc.type.codeC - Journal Articles
gro.date.issued2011
gro.hasfulltextNo Full Text
gro.griffith.authorGillis, David


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