Treatment of multiple sclerosis with rituximab: A multicentric Italian–Swiss experience

Chiara Zecca, Francesca Bovis, Giovanni Novi, Marco Capobianco, Roberta Lanzillo, Jessica Frau, Anna Maria Repice, Bahia Hakiki, Sabrina Realmuto, Simona Bonavita, Erica Curti, Laura Brambilla, Giorgia Mataluni, Paola Cavalla, Alessia Di Sapio, Elisabetta Signoriello, Stefania Barone, Giorgia T. Maniscalco, Ilaria Maietta, Isabella MaraffiGiacomo Boffa, Simona Malucchi, Agostino Nozzolillo, Giancarlo Coghe, Claudia Mechi, Giuseppe Salemi, Antonio Gallo, Rosaria Sacco, Maria Cellerino, Maria Malentacchi, Marcello De Angelis, Lorena Lorefice, Eliana Magnani, Elio Prestipino, Francesca Sperli, Vincenzo Brescia Morra, Giuseppe Fenu, Alessandro Barilaro, Gianmarco Abbadessa, Alessio Signori, Franco Granella, Maria Pia Amato, Antonio Uccelli, Claudio Gobbi, Maria Pia Sormani

Research output: Contribution to journalArticlepeer-review


Background: Rituximab, an anti-CD20 monoclonal antibody leading to B lymphocyte depletion, is increasingly used as an off-label treatment option for multiple sclerosis (MS). Objective: To investigate the effectiveness and safety of rituximab in relapsing–remitting (RR) and progressive MS. Methods: This is a multicenter, retrospective study on consecutive MS patients treated off-label with rituximab in 22 Italian and 1 Swiss MS centers. Relapse rate, time to first relapse, Expanded Disability Status Scale (EDSS) progression, incidence of adverse events, and radiological outcomes from 2009 to 2019 were analyzed. Results: A total of 355/451 enrolled subjects had at least one follow-up visit and were included in the outcome analysis. Annualized relapse rate significantly decreases after rituximab initiation versus the pre-rituximab start year in RRMS (from 0.86 to 0.09, p <.0001) and in secondary-progressive (SP) MS (from 0.34 to 0.06, p <.0001) and had a slight decrease in primary-progressive (PP) MS patients (from 0.12 to 0.07, p = 0.45). After 3 years from rituximab start, the proportion of patients with a confirmed EDSS progression was 14.6% in the RRMS group, 24.7% in the SPMS group, and 41.5% in the PPMS group. No major safety concerns arose. Conclusion: Consistently with other observational studies, our data show effectiveness of rituximab in reducing disease activity in patients with MS.

Original languageEnglish
JournalMultiple Sclerosis Journal
Publication statusAccepted/In press - Jan 1 2019


  • multiple sclerosis
  • primary progressive
  • real life
  • relapsing–remitting
  • Rituximab
  • secondary progressive

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology


Dive into the research topics of 'Treatment of multiple sclerosis with rituximab: A multicentric Italian–Swiss experience'. Together they form a unique fingerprint.

Cite this