Efficacy Observation of Low-Dose Rituximab Combined with Methylprednisolone in the Sequential Treatment of Neuromyelitis Optica Spectrum Disorders
Objective To investigate the clinical efficacy of low-dose rituximab combined with methylprednisolone in the sequential treatment of neuromyelitis optica spectrum disorders(NMOSD).Methods A total of 112 patients with NMOSD admitted to the hospital from January 2017 to June 2020 were selected and randomly divided into the observation group and the control group,with 56 cases in each group.The patients in the two groups were given the intravenous pulse therapy with Methylprednisolone Sodium Succinate for Injection(1 000 μg/d)for 3-5 d,and the dosage gradually decreased to 125 mg/d,then the above therapy was replaced with oral Methylprednisolone Tablets(48 mg/d),with the dosage decreasing to 4 mg/d for maintenance or drug withdrawal.On this basis,the patients in the observation group were given the intravenous drip with 100 mg of Rituximab Injection for four weeks,once a week,repeating treatment after six to twelve months.Results After treatment,the annual recurrence rate and Expanded Disability Status Scale(EDSS)score in the observation group were significantly lower than those in the control group(P<0.05),the T lymphocytes CD3 +,CD4 + levels and CD4 +/CD8 + in peripheral blood were significantly higher than those in the control group(P<0.05),the serum interleukin-6(IL-6),interleukin-17(IL-17)and tumor necrosis factor-α(TNF-α)levels were significantly lower than those in the control group(P<0.05).After treatment,the aspartate aminotransferase(AST),alanine aminotransferase(ALT),blood urea nitrogen(BUN)and serum creatinine(SCr)levels in the two groups were similar to those before treatment(P>0.05).The incidence of adverse reactions in the observation group was similar to that in the control group(7.14%vs.12.50%,P>0.05).Conclusion Low-dose rituximab combined with methylprednisolone in the sequential treatment of NMOSD can effectively improve the condition and inflammatory status of patients,and improve their immune function.
国家科技期刊平台
NSTL
万方数据
