Multiple sclerosis : rituximab, an old treatment which is not reimbursed more effective than the new
Published the 20.01.2018 at 15h32
multiple sclerosis plaqueimmunothérapiesrituximab
In the case of multiple sclerosis, a chronic autoimmune disease, the treatments referred to immunological abound now. But the results are often mixed. It is highly difficult to treat the inflammation in the brain and spinal cord.
Studies have shown that a class of white blood cells, B lymphocytes, may be implicated in the pathology of MS. This characteristic has led to a resurgence of interest in treatments to control the activity of B-cells in the nervous system. Rituximab belongs to the class of monoclonal antibodies, and it is able to decrease the number of B-lymphocytes in the cerebrospinal fluid. A research team is interested in its overall profit in real life on the SEP.
A study in real life
Only a few studies controlled term have shown effectiveness of rituximab, which, however, became a adjunctive therapy used without the authorization of placing on the market in this indication in many countries. The Swedish researchers then turned to the interest of rituximab in real life and on the long-term.
In this study, comprising a sample of 494 patients with a multiple sclerosis recent 2 counties in sweden (where the data of the patients are well collected), the percentage of effectiveness of the treatment and especially the duration of medication use (inverse of the rate of dropout from treatment) are significantly higher for rituximab compared to all other treatments currently available (fumarate, fingolimod, natalizumab, etc.).
Rituximab overall better
In the framework of this study conducted in real life and on for about 4 years, the researchers arrive at a conclusion clear and concise : the rituximab is superior to all other treatments.
It has a better clinical efficacy compared to other injectable treatments, such as the fumarate, natalizumab, and fingolimod. The Swedish county in which the rituximab has been the main choice in the initial treatment shows the best results on most assessment criteria.
Especially, the actual length of use (inverse of the rate of abandonment of treatment), which corresponds to the compromise efficacy and tolerance of a drug, shows that rituximab is incomparably higher.
The rituximab is more effective clinically and radiologically that the fumarate and fingolimod and much better tolerated than natalizumab, the latter having been mainly stopped for side effects.
A first-line treatment
Unfortunately, this drug, which is used in lymphoma, chronic lymphocytic leukemia, and immunological diseases such as rheumatoid arthritis and vasculitis, is now génériqué. It is, therefore, very unlikely that studies should be undertaken by a laboratory to generic, except to motivate the government to do, unless you have the desire to make savings, because there is now much less expensive.
The team’s research shows, however, unanimous : “The results suggest that rituximab is more effective than other immune-based therapies commonly used in patients with a relapsing-remitting form of multiple sclerosis,” concluded the lead author of the study.
Because of its lower price, rituximab may even be considered as a first-line option for according to the authors of the study.