Rituximab for the Treatment of Myasthenia Gravis: A 2021 Update


( Last Updated : April 19, 2021)
Project Line:
Health Technology Review
Project Sub Line:
Rapid Review
Project Number:
RC1337-000

Details


Question


  1. What is the clinical effectiveness of rituximab induction therapy for the treatment of myasthenia gravis for those who are refractory to standard therapy?

  2. What is the clinical effectiveness of rituximab re-treatment for the treatment of myasthenia gravis?

  3. What is the clinical effectiveness of rituximab maintenance therapy for the treatment of myasthenia gravis?

  4. What is the cost-effectiveness of rituximab therapy for the treatment of myasthenia gravis?

  5. What are the evidence-based guidelines regarding the use of rituximab for the treatment of myasthenia gravis?


Key Message

Low-quality evidence suggests that treatment with rituximab may be associated with improvements in clinical status, use of concurrent immunomodulatory therapies, quality of life, and various laboratory parameters in patients with myasthenia gravis, compared to before treatment. However, substantial methodological limitations of the included literature limit the use of these findings for informing clinical and policy decisions. Adverse events associated with the use of rituximab were relatively common, occurring in approximately 25% to 45% of patients treated with rituximab. The adverse events experienced by patients were not considered serious by primary study authors. No studies were identified that compared the effectiveness of rituximab to other therapies for the treatment of myasthenia gravis. Summarized studies lacked control groups, meaning that any outcomes observed in study participants should not be attributed to rituximab alone. There is a lack of evidence on the cost-effectiveness of rituximab for the treatment of myasthenia gravis. Additionally, no evidence-based guidelines were identified.