Curative Effect And Safety Analysis Of Rituximab In Treatment Of Neuromyelitis Optica

Background: Neuromyelitis optica(NMO)is an acute or subacute inflammatory demyelinating disease of primary central nervous system,that immune-mediated of optic nerve and spinal cord simultaneously or successively suffered.As early as 1870,British doctor Sir Tomas Allbutt noticed that vision lost can be combined with the spinal cord disease.They found one patient with ocular symptoms in five cases of acute myelitis.In 1894 Devic and his student Gault reviewed the previous reported in the literature of 16 cases and 2 cases of both eye blindness that they received and cured.These patients were accompanied by transverse or ascending myelitis within few days or weeks.So the NMO was also known as the Devic Disease later.NMO was commom in non-white people,such as Japanese,Chinese and other Asian people,and was rare in Caucasians such as European and the American and other western people.The symptoms of NMO was serious than Multiple Sclerosis.The recurrence rate was higher than that of Multiple Sclerosis,and the prognosis of NMO was worse than that of Multiple sclerosis.Within 5 years,about half of the patients had serious monocular vision lost or even blindness,and 70 percentage of NMO patients resulted in severely paralyzed.The patients brought heavy burden to their family and to the country.Therefore,it was of great practical to seek effective treatment for improvement of symptoms and decrease of recurrence.In recent years,related research of home and abroad showed that rituximab can effectively improve symptoms,reduce recurrence and delay the progress of disability in patients of NMO.Objective: To evaluate the efficacy and safety of rituximab in the treatment of Neuromyelitis optica.Method: A total of 62 patients with Neuromyelitis optica were randomly divided into two groups,23 cases in research group,and 39 cases in control group.All the patients signed the informed consent before treatment.The control group was given hormone shock therapy,and given Cyclophosphamide intravenous drip in the remission phase.The research group was given rituximab in the remission phase,on the basis of acute phase hormone shock therapy.Before and after 9 weeks of treatment,Two groups of patients were respectively given part components scores of EDSS including the functions of cone system,the brain,brain stem,visual or optic nerve,sensory,bladder rectum,and the ability to assess China's eye examination,daily life activities,and observation of adverse reactions after treatment of rituximab.In the follow-up of patients with 2 year after treatment,to understand recurrence or not.Results: After 9 weeks of treatment,the vision,daily life activities ability of research group improved,was better than the control group(P<0.05).The change of EDSS part component scores in research group is better than that in control group,functional recovery is better than the control group(P<0.05).TRX does not appear serious adverse reactions,the medicine had mild adverse reactions for the first time,the drug adverse reaction was not to appear again in the later three therapy.Follow-up two years after treatment,The recurrence of research group significantly lower than the control group.Conclusion: The combination of RTX and hormone shock therapy produces a significant therapeutic effect on NMO.Neurological function and vision were remarkably improved.The ability of daily life was improved.The disability rate was been reduced.The procedure is safe and of good efficacy.At the same time the recurrence rate is also markedly reduced after treatment.