{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T08:52:50Z","timestamp":1791622370830,"version":"4.3.4"},"reference-count":35,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T00:00:00Z","timestamp":1773878400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Mult Scler"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Higher cumulative rituximab doses are associated with greater risks of infections. Therefore, we routinely extend low-dose rituximab (500\u2009mg) intervals in people with relapsing multiple sclerosis (pwRMS) from every 6(q6mo) to 12\u2009months(q12mo) to 18(q18mo) and\/or 24\u2009months(q24mo).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To determine whether q18\u201324mo extension increases disease activity risks compared to continuing q6\u201312mo intervals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study of rituximab-treated pwRMS with no evidence of disease activity (absence of relapses, MRI disease activity and disability progression, NEDA-3, 96.6%) during the first year on rituximab.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      We identified 1052 patients (mean age\u2009=\u200938.5\u2009years; 71.5% female). 467 (44.4%) pwRMS received at least one q18\u201324mo 500\u2009mg interval and 585 never extended beyond q6\u201312mo. Relapses and\/or MRI disease activity (2.4%) and failing NEDA-3 (2.9%) were uncommon. Extending dosing to q18\u201324mo was not associated with an increased risk of failing NEDA-3 in inverse probability of treatment weighting propensity-score adjusted intention-to-treat (hazard ratio [HR]\u2009=\u20090.57, 95%CI\u2009=\u20090.21\u20131.57,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.275) or per-protocol analyses (HR\u2009=\u20090.56, 95%CI\u2009=\u20090.17\u20131.86, p\u2009=\u20090.348) over 3\u20135\u2009years of follow-up.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Extending low-dose rituximab after at least 1\u2009year of clinical and radiological stability up to q24mo was not associated with an increased risk of disease activity compared to continuing q6\u201312mo intervals in this large, population-based cohort.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13524585261430130","type":"journal-article","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T07:21:06Z","timestamp":1773904866000},"page":"409-420","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["De-escalating low-dose rituximab up to every 24-month infusions and the risk of disease activity in people with relapsing multiple sclerosis who were stable the first year on therapy"],"prefix":"10.1177","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6891-7147","authenticated-orcid":false,"given":"Annette M","family":"Langer-Gould","sequence":"first","affiliation":[{"name":"Department of Neurology, Los Angeles Medical Center, Southern California Permanente Medical Group, Los Angeles, CA, USA; Department of Clinical Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica B","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Research &amp; Evaluation, Southern California Permanente Medical Group, Pasadena, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allen Scott","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Department of Neurology, Fontana Medical Center, Southern California Permanente Medical Group, Fontana, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandon E","family":"Beaber","sequence":"additional","affiliation":[{"name":"Department of Neurology, Downey Medical Center, Southern California Permanente Medical Group, Downey, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonu M","family":"Brara","sequence":"additional","affiliation":[{"name":"Department of Neurology, Panorama City Medical Center, Southern California Permanente Medical Group, Panorama City, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samira","family":"Amirova","sequence":"additional","affiliation":[{"name":"Department of Neurology, Los Angeles Medical Center, Southern California Permanente Medical Group, Los Angeles, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elaine","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Neurology, Los Angeles Medical Center, Southern California Permanente Medical Group, Los Angeles, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bonnie H","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Research &amp; Evaluation, Southern California Permanente Medical Group, Pasadena, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neda","family":"Z Esfahani","sequence":"additional","affiliation":[{"name":"Department of Neurology, Capitol Hill Medical Office, Washington Permanente Medical Group, Seattle, WA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"Torres","sequence":"additional","affiliation":[{"name":"Department of Radiology, Los Angeles Medical Center, Southern California Permanente Medical Group, Los Angeles, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stanley","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Research &amp; Evaluation, Southern California Permanente Medical Group, Pasadena, CA, USA; Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,3,19]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0706383"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awae409"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1212\/NXI.0000000000200211"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1212\/NXI.0000000000000734"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000208063"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000214473"},{"key":"e_1_3_2_8_2","first-page":"1334","article-title":"Rituximab long-term DOSE trial in multiple sclerosis\u2014RIDOSE-MS. 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