Effect of Rituximab on the Cognitive Impairment in Patients with Secondary Progressive Multiple Sclerosis

Overview

Journal Caspian J Intern Med

Specialty General Medicine

Date 2022 Aug 17

PMID 35974939

Authors

Saeideh Salehizadeh

Roghayyeh Saeedi

Mohammad Ali Sahraian

Hossein Rezaei Aliabadi

Seyedeh Nafiseh Hashemi

Sharareh Eskandarieh

Mohammad Reza Gheini

Shaghayegh Shahmirzaei

Mahsa Owji

Abdorreza Naser Moghadasi

Affiliations

Soon will be listed here.

Abstract

Background: The present study aimed to address the effect of Rituximab on the cognitive impairment in patients with secondary progressive MS (SPMS).

Methods: The present interventional study used a convenience sampling method to select the study participants from SPMS patients. All these patients had progressive disability over the last two years before being admitted in the study. Prior to the administration of Rituximab, the minimal assessment of cognitive function in the multiple sclerosis (MACFIMS) test was performed for each patient who was a candidate to be included in this study. This test was repeated by passing 6 and 12 months from the initial treatment with Rituximab. Since the data needed for this study were obtained at different time intervals, so a linear mixed model was used for their analysis. Analysis of variance (ANOVA) was also used to investigate whether time and sex generally affect the cognitive impairments in SPMS patients. A p-value <0.05 was considered as statistically significant in this study.

Results: Of the total 35 patients, 34% and 66% were men and women with a mean age of 41.33 and 41.39 years old, respectively. Rituximab showed a significant positive effect on a number of subgroups of MACFIMS test, including Controlled Oral Word Association Test (COWAT) (P-value: 0.038) and Brief Visuospatial Memory Test (BVMT-total) (P: 0.019).

Conclusion: The present study revealed that Rituximab has a positive effect on the cognitive impairment resulted from MS in secondary progressive patients.

Citing Articles

Rituximab in secondary progressive multiple sclerosis: a meta-analysis.

Intarakhao P, Laipasu T, Jitprapaikulsan J, Apiraksattayakul N, Kosiyakul P, Siritho S Ann Clin Transl Neurol. 2024; 11(10):2707-2718.

PMID: 39186371 PMC: 11514939. DOI: 10.1002/acn3.52186.

References

Barak Y, Achiron A . Effect of interferon-beta-1b on cognitive functions in multiple sclerosis. Eur Neurol. 2002; 47(1):11-4. DOI: 10.1159/000047940. View

Castillo-Trivino T, Braithwaite D, Bacchetti P, Waubant E . Rituximab in relapsing and progressive forms of multiple sclerosis: a systematic review. PLoS One. 2013; 8(7):e66308. PMC: 3699597. DOI: 10.1371/journal.pone.0066308. View

Alldredge B, Jordan A, Imitola J, Racke M . Safety and Efficacy of Rituximab: Experience of a Single Multiple Sclerosis Center. Clin Neuropharmacol. 2018; 41(2):56-59. DOI: 10.1097/WNF.0000000000000268. View

Berntsson S, Kristoffersson A, Bostrom I, Feresiadou A, Burman J, Landtblom A . Rapidly increasing off-label use of rituximab in multiple sclerosis in Sweden - Outlier or predecessor?. Acta Neurol Scand. 2018; 138(4):327-331. DOI: 10.1111/ane.12963. View

Penner I, Stemper B, Calabrese P, Freedman M, Polman C, Edan G . Effects of interferon beta-1b on cognitive performance in patients with a first event suggestive of multiple sclerosis. Mult Scler. 2012; 18(10):1466-71. PMC: 3573673. DOI: 10.1177/1352458512442438. View

Mattioli F, Stampatori C, Bellomi F, Scarpazza C, Capra R . Natalizumab Significantly Improves Cognitive Impairment over Three Years in MS: Pattern of Disability Progression and Preliminary MRI Findings. PLoS One. 2015; 10(7):e0131803. PMC: 4492934. DOI: 10.1371/journal.pone.0131803. View

Goldenberg M . Multiple sclerosis review. P T. 2012; 37(3):175-84. PMC: 3351877. View

Lorscheider J, Buzzard K, Jokubaitis V, Spelman T, Havrdova E, Horakova D . Defining secondary progressive multiple sclerosis. Brain. 2016; 139(Pt 9):2395-405. DOI: 10.1093/brain/aww173. View

Naegelin Y, Naegelin P, von Felten S, Lorscheider J, Sonder J, Uitdehaag B . Association of Rituximab Treatment With Disability Progression Among Patients With Secondary Progressive Multiple Sclerosis. JAMA Neurol. 2019; 76(3):274-281. PMC: 6439730. DOI: 10.1001/jamaneurol.2018.4239. View

10.

de Flon P, Laurell K, Soderstrom L, Gunnarsson M, Svenningsson A . Improved treatment satisfaction after switching therapy to rituximab in relapsing-remitting MS. Mult Scler. 2016; 23(9):1249-1257. DOI: 10.1177/1352458516676643. View

11.

Trenova A, Slavov G, Manova M, Aksentieva J, Miteva L, Stanilova S . Cognitive Impairment in Multiple Sclerosis. Folia Med (Plovdiv). 2016; 58(3):157-163. DOI: 10.1515/folmed-2016-0029. View

12.

Alcala C, Gascon F, Perez-Miralles F, Gil-Perotin S, Navarre A, Bosca I . Efficacy and safety of rituximab in relapsing and progressive multiple sclerosis: a hospital-based study. J Neurol. 2018; 265(7):1690-1697. DOI: 10.1007/s00415-018-8899-3. View

13.

Comi G, Patti F, Rocca M, Mattioli F, Amato M, Gallo P . Efficacy of fingolimod and interferon beta-1b on cognitive, MRI, and clinical outcomes in relapsing-remitting multiple sclerosis: an 18-month, open-label, rater-blinded, randomised, multicentre study (the GOLDEN study). J Neurol. 2017; 264(12):2436-2449. PMC: 5688215. DOI: 10.1007/s00415-017-8642-5. View

14.

Naser Moghadasi A, Darki A, Masoumi P, Hashemi S, Ghadiri F . Evaluating the efficacy and safety of Zytux (Rituximab, AryoGen pharmed) in Iranian multiple sclerosis patients: An observational study. Mult Scler Relat Disord. 2019; 36:101419. DOI: 10.1016/j.msard.2019.101419. View

15.

Planche V, Gibelin M, Cregut D, Pereira B, Clavelou P . Cognitive impairment in a population-based study of patients with multiple sclerosis: differences between late relapsing-remitting, secondary progressive and primary progressive multiple sclerosis. Eur J Neurol. 2015; 23(2):282-9. DOI: 10.1111/ene.12715. View

16.

Monson N, Cravens P, Frohman E, Hawker K, Racke M . Effect of rituximab on the peripheral blood and cerebrospinal fluid B cells in patients with primary progressive multiple sclerosis. Arch Neurol. 2005; 62(2):258-64. DOI: 10.1001/archneur.62.2.258. View

17.

Alirezaei M, Forouzannia S, Yarahmadi P, Sahraian M, Owji M, Bidadian M . Demographic features, behavioral measures, and clinical factors as predictors of cognitive function in patients with multiple sclerosis. Mult Scler Relat Disord. 2021; 49:102758. DOI: 10.1016/j.msard.2021.102758. View

18.

Grzegorski T, Losy J . Cognitive impairment in multiple sclerosis - a review of current knowledge and recent research. Rev Neurosci. 2017; 28(8):845-860. DOI: 10.1515/revneuro-2017-0011. View

19.

Toogeh G, Faranoush M, Razavi S, Jalaeikhoo H, Allahyari A, Ravanbod M . A Double-Blind, Randomized Comparison Study between Zytux™ vs MabThera® in Treatment of CLL with FCR Regimen: Non-Inferiority Clinical Trial. Int J Hematol Oncol Stem Cell Res. 2018; 12(2):84-91. PMC: 6141434. View

20.

Huijbregts S, Kalkers N, de Sonneville L, de Groot V, Reuling I, Polman C . Differences in cognitive impairment of relapsing remitting, secondary, and primary progressive MS. Neurology. 2004; 63(2):335-9. DOI: 10.1212/01.wnl.0000129828.03714.90. View