Rituximab is safe and effective in patients with moderate to severe juvenile myasthenia gravis (MG), according to an international cohort and literature review published in the European Journal of Paediatric Neurology. The study reported that most patients had an improvement in their symptoms following treatment.

In adults with MG, rituximab treatment is considered in cases of refractory disease but only under the supervision of an experienced physician. It is also increasingly being considered for the treatment of refractory juvenile MG even though it has not been well studied in this patient group.

In the present study, a team of researchers led by Heinz Jungbluth, MD, PhD, a professor of pediatric neurology and a consultant pediatric neurologist at King’s College London in England conducted a retrospective study in 10 patients with juvenile MG who were treated with rituximab.

The results of the study showed that all patients had a reduction in hospital admissions due to their diseae following rituximab treatment. 

Read more about the experimental therapies for MG

At the 24-month follow-up, the researchers found that more than half of the patients (6) achieved complete stable remission or pharmacological remission. Moreover, 7 patients were able to reduce their immunomodulatory treatments.

The main adverse effect associated with rituximab treatment was infusion-related reactions seen in 3 patients. However, this was resolved with symptomatic treatment. 

The researchers also compared their patients to cases reported in the literature of juvenile MG treated with rituximab. They found that these had similar response rates albeit slightly higher adverse effect profiles.

A patient is said to have juvenile MG if he or she is aged younger than 18 years and affected by the disease. The pathophysiology of the disease is similar in children to that in adults with antibody or complement-mediated disruption of the neuromuscular junction.

Rituximab is a chimeric murine-human monoclonal antibody that targets CD20 and induces B cell depletion.

Reference

Ramdas S, Della Marina A, Ryan MM, et al. Rituximab in juvenile myasthenia gravis-an international cohort study and literature review. Eur J Paediatr Neurol. Published online June 25, 2022. doi:10.1016/j.ejpn.2022.06.009