At a time when new therapeutic families are emerging in autoimmune myasthenia, an “old” treatment (rituximab) could play a new role. Indicated until now in refractory forms of the disease, it has just been evaluated in recent generalised myasthenia (12 months or less) by the phase III clinical trial Rinomax, conducted in Sweden in 47 adults:
- 25 received an intravenous infusion of 500mg rituximab, 22 received a placebo infusion;
- 16 weeks later, 71% of participants in the rituximab group and 29% of those in the placebo group had an MGQ score of 4 or less on prednisone 10mg/day or less, without the need for additional treatment (primary endpoint of the trial);
- 4% of participants in the rituximab group and 36% of those in the placebo group required additional treatment (IVIG, other biotherapies, etc.) within 24 weeks after injection;
- all three hospitalizations due to myasthenia exacerbations occurred in the placebo group.
These results suggest that rituximab may be effective when started earlier and that a single, reduced dose is sufficient.
