% 0期刊文章% Stanislas德穆斯%尼古拉斯Collongues %一个Xavier Bertrand Audoin % Ayrignac Jonathan Ciron % Bertrand Bourre % %一个罗曼·德尚米凯尔·科恩% %的弗朗索瓦丝Durand-Dubief %一个伊丽莎白Maillart %卡罗琳Papeix % Aurelie Ruet %一个Romain Marignier海琳Zephir % %的杰罗姆·德Seze % NOMADMUS研究小组% T美罗华降级视Neuromyelitis谱系障碍患者% D R 10.1212 / WNL 2023%。0000000000207443 % J半岛投注体育官网神经病学% P e438-e450 % V 101% N 4% X退出战略背景和目标如降级并没有评价利妥昔单抗视neuromyelitis谱系障碍患者(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: 0.79–9.5), 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 [4.7–15.9]), from 0.69 to 10.0 months, and in 5/18 de-escalations in patients with AQP4− NMOSD (27.8%, 95% CI [9.7–53.5]), 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 %U //www.ebmtp.com/content/neurology/101/4/e438.full.pdf