Is rituximab useful in ocular myasthenia gravis?

Chinese clinicians report encouraging results regarding the use of rituximab, an anti-CD20 monoclonal antibody, in forms of ocular myasthenia gravis:

  • their pilot study involved 9 adult patients treated between 2023 and 2024 with a low dose of rituximab (200 mg),
  • all of whom were seropositive for acetylcholine receptor (AChR) antibodies,
  • the treatment led to a significant and rapid improvement (within a few weeks in 8 out of 9 cases) both clinically (ptosis and diplopia, functional scores) and biologically (decrease in anti-AChR autoantibody levels),
  • it led to a significant reduction in corticosteroid therapy, with stable results at one year.

The results of this study add to the highly debated issue of second-line treatments for this supposedly less severe form of autoimmune myasthenia gravis.

 

Low-dose rituximab in AChR antibody-positive ocular myasthenia gravis: Efficacy and safety-A preliminary study. Mao B, Wang R, Liu X, et al. Medicine (Baltimore). 2025 Oct