Original research article
Porto Biomed. J. 2017; 2(3): 81-85 doi: http://dx.doi.org/doi:10.1016/j.pbj.2017.02.002 (Published 11 March 2017)

Rituximab in generalized myasthenia gravis: Clinical, quality of life and cost–utility analysis

João Peresa,*, Rita Martinsa,*,José Delgado Alvesb,*, Ana Valverdea,*

Department of Neurology, Fernando Fonseca Hospital, Amadora, Portugal
Immunomediated Systemic Diseases Unit (UDIMS), Internal Medicine 4, Fernando Fonseca Hospital, Amadora, Portugal
*Corresponding author:
Accepted 4 February 2017
abstract
Introduction: Myasthenia Gravis is a humoral autoimmune disorder affecting the neuromuscular junction. Its treatment is based on immunosuppressive agents. Rituximab has shown efficacy in refractory and severe Myasthenia Gravis. We evaluate the potential pharmacoeconomic and quality of life benefits of its use. Methods: A retrospective analysis of Myasthenia Gravis patients treated with Rituximab was performed. Clinical charts were reviewed and scales for assessment of quality of life were applied. Health care costs were estimated based on the average of each treatment and daily charge of hospitalization. Results: Six patients were treated. Rituximab use lead to the reduction of relapses and to a lesser use of immunosuppressive agents. An overall decrease in healthcare costs after treatment was observed along with an evident clinical improvement. Discussion: Rituximab is a clinical effective treatment for B cell-related diseases like MG and seems to be a cost–saving intervention. Its use is associated with a decrease in the need for other immunosuppressive treatments whilst improving quality of life and reducing health costs.

Abbreviations: Abs, antibodies; AchR, muscle acetylcholine receptor; IVIg, intravenous immunoglobulin; MG, myasthenia gravis; MGFA-PIS, myasthenia gravis foundation of America-post interventional status; MGCS, myasthenia gravis composite scale; MuSK, muscle-specific tyrosine-kinase; PEX, plasma exchange; QALY, quality-adjusted life years; RA, rheumathoid arthritis; RTX, rituximab; SLE, systemic lupus erythematous
keywords
Myasthenia gravis; Rituximab; Immunosuppression; QALY; Cost–utility
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