Observation Of Clinnical Efficacy Of Different Dose Of Rituximab Therapy In Neuromyelitis Optica Spectrum Disorders

Objective:Observe differences of two-dose rituximab(RTX) in B-cell delete, B cell levels of ma intenance and reduce in relapse, EDSS score and the number of MRIT2 lesions of neuromyelitis optica spectrum disorders(NMOSD), then assess which dose was efficacy and safety.Methods:Respectively 100 / 300 mg of RTX,once a week,which was gave to 19 cases of patients who were diagnosed with NMO and NMOSD in first hospital of Shanxi Medical University from2014.10 to 2016.02, then reviewed CD19 + ratio after two weeks and used the dose continuously three times.Reviewed CD19 + ratio every eight weeks,if the result >1%,we would give RTX a time additional.Prospective analysis 100mg/300 mg RTX average relapse frequency before and after treatment(ARR), Expanded Disability Status Scale(EDSS) score, MRI T2 lesion counts evaluate its therapeutic effect, B lymphocyte subsets CD19 + ratio guide RTX treatment, clinical symptoms and biochemical binding immunoglobulin understand RTX security.Results:A total of 19 patients, including four cases NMOSD and 15 cases NMO, 16 patients(84.2%) without recurrence, 3 cases(15.8%) patients with ARR reduction, ARR by the overall average(1.13 ± 0.43) reduced( 0.13 ± 0.33)(P <0.001); the overall average Expanded Disability Status Scale(EDSS) score from the previous(3.79 ± 2.71) treatment reduced(2.16 ± 2.20)(P <0.001); the overall average number of MRI T2 lesion before treatment(5.82 ± 2.91) reduced(4.11 ± 2.79)(P <0.05); 100 mg, 300 mg before and after treatment ARR, the average EDSS score, MRI T2 lesion counts was statistically significant(P <0.05), but still can not believe Interaction ARR, the average EDSS score improved dose MRI T2 lesion count was statistically significant between(P> 0.05). 16 cases(84.2%)occurred throat tightness, shortness of breath, after spontaneous remission; systemic herpes zoster, frequent upper respiratory tract infection.Conclusion:Management recommends that RTX treatment was extended from six months to 8.5-9months, 100mg/300 mg RTX treat NMOSD no significant difference in efficacy, considered a good choice for low-dose RTX from long-term efficacy, safety, prices...