The Role of Rituximab in the Treatment of Myasthenia Gravis

Table 1: Characteristics and Response to Rituximab Treatment in 53 Patients with Myasthenia Gravis Ref Age, MG Previous

MGFA CC Sex Type Treatments

25 27, M AChR+ S, ASTC, CA, I 26 9, F

AChR+ S, P, I, A 15 79, F AChR+ C, S

Immediately Before RTX

IVb IVb

Estimated III

RTX Given for Lymphoma 27 56, F MuSK+ S, I, P, A, M IVb

28 32, M MuSK+ S, A, P, I, CA, M, C

IVb V

Ab Titre Before RTX

55nM 7.3nM 12nM

NR NR

29 21, F MuSK+ S, I, P, A, M Estimated IVb NR 30 46, F AChR+ S, I, CA MuSK+ VGKC+

31 NR, F MuSK+ S, A, CA, M, P IVb 32 75, M AChR+ S, I, Mx

IIa

RTX Given for Lymphoma 33 50, F AChR+ S, Mx, A, I, P

RTX Given for Rheumatoid Arthritis 34 11, M AChR+ S, I, A, M

Estimated IIIb

247nM 89nM

422pM NR

> 8 U 15IU/ml Estimated IVb NR

After RTX Failure, Successfully Treated by ASCT 35 14, F AChR+ S, A, M, C, ASCT Estimated IVb NR

36 76, M AChR+ S, I, P VGKC+

37 71, M AChR+ P, Mx

RTX Given for Lymphoma 38 52, F MuSK+ S, A, CA, M,

C, I

54, F MuSK+ S, A, C, M, I 30, F MuSK+ S, I

50, M AChR+ S, A, C, I 31, F AChR+ S, A, C, M, I 73, F AChR+ S, A, I

Patient 4 Had a Malignant Thymoma 40 44, F AChR+ S, P

11, F AChR+ S, A, M NR, F NR

S, I, P

IVb V

IVb IVb IVb

Estimated IVb Estimated IVb

50nM 63nM

262nM

2,739nM 88nM

3.47nM 19.8nM

Estimated IIIb NR

Patients 1 and 3 Also Treated for a Malignant Thymoma 39 59, F MuSK+ S, I, A, C, P, M Estimated IVb NR

45, NR AChR+ S, A, C, P, M, I 27, NR MuSK+ S, A, C, P, M, I, CA

50, NR MuSK+ S, A, C, I

Estimated IVb NR Estimated IVb NR

Estimated IVb NR

41 32, F AChR+ S, A, CA, M, P Estimated IVb 75nM 45, F MuSK+ S, I, P 21, F AChR+ S, A

42 75, M AChR+ S, I 43 24, F AChR+ S, CA, M

Estimated IIIb NR Estimated IIb Estimated IIb

62, M MuSK+ S, A, Mx, CA, C Estimated IVb

36, M AChR+ S, CA, A, M Estimated IVb 31, F AChR+ S, I, M

Estimated IVb

Patient 3 Also Treated for a Malignant Thymoma 44 33, F MuSK+ S, M, P

38, F MuSK+ S, P, I

57, F MuSK+ S, A, CA, P 31, F MuSK+ S, P

53, F AChR+ S, A, P, I 55, F AChR+ S, A, P

EUROPEAN NEUROLOGICAL REVIEW BL x1/2

220nM NR

0.23nM

Estimated IVb >100nM 8.2nM

Estimated IVb 46nM

12, F AChR+ S, A, Mx, P, I, M Estimated IVb 212nM 19, M AChR+ S, A, P, CA, I

9.4nM

Estimated IIIa NR Estimated IIIa NR Estimated IVb NR Estimated IIIb NR Estimated IVb

Estimated IIIb NR

1g x2 BL BL BL BL BL BL

1.61nM

BL BL BL BL BL BL

BL BL

N N N

Y (9) Y (7) Y (7)

Y (5) Y (3) Y (3) Y (3) N N

Y (1) N

Y (2) Y (1) Y (2)

Y (3) Y (1) Y (4) Y (1) Y (3) Y (2)

48 24 24

24

NR NR

NR 33 27 24

NR NR 48 60 29 12 30

21 6

24 6

15 6

MM 16nM MM 0.6nM Im Im Im

CSR NR

MM NR MM NR

CSR CSR CSR

CSR

Undetectable Undetectable Undetectable

Undetectable

MM 110nM MM NR

MM 150nM MM NR

MM 0.39nM CSR I

D I I

60nM 3.6nM 9.3nM 350nM NR

MM NR Im

NR

MM NR MM NR

MM 0.19nM Im

NR 97 171nM

2,149nM 30nM

V

192IU/ml 235IU/ml

Estimated IVb 310nM IVb 7.5nM

Initial Dose Other of RTX

BL BL BL

BL BL

BL BL

NR BL

BL BL BL 1g x 2 BL BL

N N

Y (1)

Y (1) Y (1)

Y (1) N

N Y (7) Y (2) N

Y (2) N

Y (1) Y (2)

Cycles of RTX (n)

Follow-up Duration

Post-(first) RTX (months)

6

22 14

4 18

13 9

7 24 36 NR

25 18

14 9

MM 15nM MM 1.5nM Im

3.66nM

MM Undetectable CSR

NR CSR NR

MM Undetectable Undetectable Undetectable NR

Im MM 1.84U MM 6IU/ml W CSR CSR 10.77nM NR MM NR but +

undetectable 13nM

MM 2nM

MGFA PS Ab Titre After RTX