This is a fascinating thread and I will address why in my next post but first I wanted to address the topic of PML using Rituxan with a couple of quotes...
"Supposedly, there are no cases of PML with rituxan in multiple sclerosis out of ~40,000 exposed patients. In one series, there were 4 total cases in rheumatoid arthritis treated with rituxan out of 129,000 exposed, suggesting risk of ~1/25,000; 1 of these 4 cases was with no biologic and minimal immunosuppressive therapy.
Source: “Rituximab-associated progressive multifocal leukoencephalopathy in rheumatoid arthritis JAMA Neurology, “09/14/2011 Clifford DB et al.
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Dr. Gavin Giovannoni Tuesday, December 16, 2014 10:16:00 am
Thanks for this. I sat on an PML advisory board several years ago and we reviewed all the PML cases linked to rituximab; we didn't find a single case on monotherapy. The one case referred to here on minimal immunosuppressive therapy had been on steroids. The take home message is that the risk of PML on rituximab is very low; the caveat being carryover PML from natalizumab. I think rituximab, and by inference ocrelizumab and other anti-CD20 therapies, will be a relatively safe drugs to transition onto from natalizumab."
http://multiple-sclerosis-research.b...l#comment-form
"Supposedly, there are no cases of PML with rituxan in multiple sclerosis out of ~40,000 exposed patients. In one series, there were 4 total cases in rheumatoid arthritis treated with rituxan out of 129,000 exposed, suggesting risk of ~1/25,000; 1 of these 4 cases was with no biologic and minimal immunosuppressive therapy.
Source: “Rituximab-associated progressive multifocal leukoencephalopathy in rheumatoid arthritis JAMA Neurology, “09/14/2011 Clifford DB et al.
Reply
Dr. Gavin Giovannoni Tuesday, December 16, 2014 10:16:00 am
Thanks for this. I sat on an PML advisory board several years ago and we reviewed all the PML cases linked to rituximab; we didn't find a single case on monotherapy. The one case referred to here on minimal immunosuppressive therapy had been on steroids. The take home message is that the risk of PML on rituximab is very low; the caveat being carryover PML from natalizumab. I think rituximab, and by inference ocrelizumab and other anti-CD20 therapies, will be a relatively safe drugs to transition onto from natalizumab."
http://multiple-sclerosis-research.b...l#comment-form
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