@article {Demuthe438作者= {Stanislas•德穆斯和尼古拉•Collongues和伯特兰Audoin Xavier Ayrignac和伯特兰Bourre乔纳森Ciron米凯尔·科恩和罗曼·德尚弗兰{\ c c}瓦兹Durand-Dubief伊丽莎白Maillart和卡罗琳Papeix与{\ ' e}躺Ruet,海琳Zephir Romain Marignier和杰罗姆·德·Seze NOMADMUS研究小组},title ={美罗华降级视Neuromyelitis谱系障碍患者},体积={101}={4},页面= {e438——e450} = {2023}, doi = {10.1212 / WNL。出版商0000000000207443}= {Wolters Kluwer健康,公司代表美国神经病学学会},文摘={背景和目标退出策略如降级并没有评价利妥昔单抗的患者视neuromyelitis半岛投注体育官网谱系障碍(NMOSD)。我们假设他们与疾病相关联而和旨在估计这种风险。方法我们描述一个案件的一系列实际降级从法国NMOSD注册(NOMADMUS)。所有患者遇到了2015年国际面板NMOSD动(IPND)诊断标准诊断。注册表的计算机筛选提取患者利妥昔单抗降级,至少12个月的后续跟踪。我们寻找7降级方案:将中止或切换到口服治疗后注入单周期,将中止或切换到口服治疗周期注入之后,降级在怀孕之前,降级后公差问题,并增加注入间隔。美罗华中止出于无效或未知的目的被排除在外。主要结果的绝对风险NMOSD复活(一个或多个复发)12个月。AQP4 +和AQP4 -血清型分别进行了分析。结果我们发现137利妥昔单抗降级在2006年和2019年之间,与一个预定义的组:13停药后一个注入周期,6开关后口服治疗一个注入循环,9日中止定期注入后,5个开关周期注入后口服治疗,怀孕前4降级,9降级后公差问题,和91年增加注入间隔。 No group remained relapse-free over the whole de-escalation follow-up (mean: 3.2 years; range: 0.79{\textendash}9.5), except pregnancies in AQP+ patients. In all groups combined and within 12 months, reactivations occurred after 11/119 de-escalations in patients with AQP4+ NMOSD (9.2\%, 95\% CI [4.7{\textendash}15.9]), from 0.69 to 10.0 months, and in 5/18 de-escalations in patients with AQP4- NMOSD (27.8\%, 95\% CI [9.7{\textendash}53.5]), from 1.1 to 9.9 months.Discussion There is a risk of NMOSD reactivation whatever the rituximab de-escalation regimen.Trial Registration Information Registered on ClinicalTrials.gov: NCT02850705.Classification of Evidence This study provides Class IV evidence that de-escalation of rituximab increases the probability of disease reactivation.AQP4-IgG=aquaporin 4-IgG; EDSS=Expanded Disability Status Scale; MOGAD=myelin oligodendrocyte glycoprotein antibody disease; MOG-IgG=myelin oligodendrocyte glycoprotein antibodies; MS=multiple sclerosis; NMOSD=neuromyelitis optica spectrum disorder; RCTs=randomized clinical trials}, issn = {0028-3878}, URL = {//www.ebmtp.com/content/101/4/e438}, eprint = {//www.ebmtp.com/content/101/4/e438.full.pdf}, journal = {Neurology} }