{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T15:29:13Z","timestamp":1788449353682,"version":"build-2803163510"},"reference-count":34,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T00:00:00Z","timestamp":1762300800000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The placebo\u2010controlled RINOMAX trial (NCT02950155) demonstrated superiority up to 12\u2009months of rituximab over standard\u2010of\u2010care in new\u2010onset generalized myasthenia gravis (MG), but benefit\u2013risk over longer time frames remains unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>RINOMAX included 47 participants with a Quantitative Myasthenia Gravis (QMG) score \u2265\u20096. Twenty\u2010five patients were randomized to a single intravenous infusion of 500\u2009mg rituximab, and 22 to placebo of which 16 received rituximab after the double\u2010blinded phase (7\u2009\u00b1\u20092.9\u2009months). Data were extracted from the Swedish MG registry to track hospitalizations, treatments including rescue, and disease activity scores.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Compared to the placebo arm, lower mean time\u2010weighted QMG scores at 12\u2009months (mean difference [MD]: 2.9, 95% CI: 0.9, 4.9;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005) and 24\u2009months (MD: 2.6, 95% CI: 0.3, 4.9;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.027) were observed in the RTX arm. The incidence rate of rescue from 48\u2009weeks up to 5\u2009years was numerically higher in the placebo arm than RTX (0.16 vs. 0.09\/person\u2010year;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.121). Compared to delayed RTX, early exposure displayed lower QMG, risk of hospitalization (HR 0.24, 95% CI 0.07, 0.83), and rescue (HR 0.46, 95% CI 0.14, 1.57), but also the six patients never receiving RTX showed lower hospitalization risk (HR 0.08, 95% CI 0.01, 0.96). Corticosteroid doses were low globally throughout. Overall, 12.5% and 18.8% and of patients with early and delayed RTX, respectively, suffered a severe infection.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Disease activity and treatment burden, including hospitalization and rescue treatments, remained low, indicating a potential benefit of rituximab on the long\u2010term disease trajectory. Infection risk with B cell depletion, however, remains a concern.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ene.70418","type":"journal-article","created":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T07:00:38Z","timestamp":1762412438000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Rituximab in New\u2010Onset Generalized Myasthenia Gravis: Long\u2010Term Follow\u2010Up of the RINOMAX Clinical Trial"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6033-3734","authenticated-orcid":false,"given":"Jing","family":"Wu","sequence":"first","affiliation":[{"name":"Institute of Environmental Medicine Karolinska Institutet  Stockholm Sweden"},{"name":"Neuroimmunology Unit, Center for Molecular Medicine Karolinska Institutet  Stockholm Sweden"},{"name":"Institutionen f\u00f6r klinisk neurovetenskap Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann","family":"Eriksson\u2010Dufva","sequence":"additional","affiliation":[{"name":"Neuroimmunology Unit, Center for Molecular Medicine Karolinska Institutet  Stockholm Sweden"},{"name":"Institutionen f\u00f6r klinisk neurovetenskap Karolinska Institutet  Stockholm Sweden"},{"name":"Neurologiska kliniken Karolinska Universitetssjukhuset  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Budzianowska","sequence":"additional","affiliation":[{"name":"Department of Neurology and Rehabilitation Ryhov Regional Hospital  J\u00f6nk\u00f6ping Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amalia","family":"Feresiadou","sequence":"additional","affiliation":[{"name":"Department of Neurology Uppsala University Hospital  Uppsala Sweden"},{"name":"Department of Medical Sciences, Section of Neurology Uppsala University  Uppsala 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