{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T06:20:45Z","timestamp":1793686845294,"version":"4.5.1"},"reference-count":75,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,10,2]],"date-time":"2023-10-02T00:00:00Z","timestamp":1696204800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:p>Myasthenia gravis (MG) is a chronic autoimmune disease mediated by antibodies against post-synaptic proteins of the neuromuscular junction. Up to 10%\u201330% of patients are refractory to conventional treatments. For these patients, rituximab has been used off-label in the recent decades. Rituximab is a monoclonal antibody against the CD20 protein that leads to B cell depletion and to the synthesis of new antibody-secreting plasma cells. Although rituximab was created to treat B-cell lymphoma, its use has widely increased to treat autoimmune diseases. In MG, the benefit of rituximab treatment in MuSK-positive patients seems clear, but a high variability in the results of observational studies and even clinical trials has been reported for AChR-positive patients. Moreover, few evidence has been reported in seronegative MG and juvenile MG and some questions about regimen of administration or monitoring strategies, remains open. In this review, we intend to revise the available literature on this topic and resume the current evidence of effectiveness of Rituximab in MG, with special attention to results on every MG subtype, as well as the administration protocols, monitoring strategies and safety profile of the drug.<\/jats:p>","DOI":"10.3389\/fneur.2023.1275533","type":"journal-article","created":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T00:28:02Z","timestamp":1696292882000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":51,"title":["Rituximab treatment in myasthenia gravis"],"prefix":"10.3389","volume":"14","author":[{"given":"Ana","family":"Vesperinas-Castro","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Cort\u00e9s-Vicente","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,10,2]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1023","DOI":"10.1016\/S1474-4422(15)00145-3","article-title":"Myasthenia gravis: subgroup classification and therapeutic strategies","volume":"14","author":"Gilhus","year":"2015","journal-title":"Lancet Neurol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1038\/s41572-019-0079-y","article-title":"Myasthenia gravis","volume":"5","author":"Gilhus","year":"2019","journal-title":"Nat Rev Dis Primers"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1186\/s12974-022-02448-4","article-title":"Independent risk factors for myasthenic crisis and disease exacerbation in a retrospective cohort of myasthenia gravis patients","volume":"19","author":"Nelke","year":"2022","journal-title":"J Neuroinflammation"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"865","DOI":"10.1007\/s40265-022-01726-y","article-title":"Pharmacotherapy of generalized myasthenia gravis with special emphasis on newer biologicals","volume":"82","author":"Menon","year":"2022","journal-title":"Drugs"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1038\/s41582-018-0110-z","article-title":"Immunotherapy in myasthenia gravis in the era of biologics","volume":"15","author":"Dalakas","year":"2019","journal-title":"Nat Clin Pract Neurol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1111\/ene.15872","article-title":"Efficacy of innovative therapies in myasthenia gravis: a systematic review, meta-analysis and network meta-analysis","author":"Sacc\u00e0","year":"2023","journal-title":"Eur J Neurol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1136\/jnnp.2005.072355","article-title":"Causes of death among patients with myasthenia gravis in Norway between 1951 and 2001","volume":"77","author":"Owe","year":"2006","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1097\/CND.0000000000000034","article-title":"Treatment-refractory myasthenia gravis","volume":"15","author":"Silvestri","year":"2014","journal-title":"J Clin Neuromuscul Dis"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"859","DOI":"10.1111\/j.1600-6143.2006.01288.x","article-title":"Rituximab, an anti-CD20 monoclonal antibody: history and mechanism of action","volume":"6","author":"Pescovitz","year":"2006","journal-title":"Am J Transplant"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"163","DOI":"10.3389\/fonc.2018.00163","article-title":"Past, present and future of rituximab-the Wordl's first oncology monoclonal antibody therapy","volume":"8","author":"Pierpont","year":"2018","journal-title":"Front Oncol"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"216","DOI":"10.1016\/j.jneuroim.2019.05.004","article-title":"Effect of low-dose rituximab treatment on T-and B-cell lymphocyte imbalance in refractory myasthenia gravis","volume":"332","author":"Jing","year":"2019","journal-title":"J Neuroimmunol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1752","DOI":"10.1016\/S0304-5412(13)70552-3","article-title":"Funciones de los linfocitos B. lymphocyte functions","volume":"11","author":"Prieto Mart\u00edn","year":"2013","journal-title":"Medicine"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"20878","DOI":"10.1073\/pnas.0709205105","article-title":"Therapeutic B cell depletion impairs adaptive and autoreactive CD4+ T cell activation in mice","volume":"104","author":"Bouaziz","year":"2007","journal-title":"Proc Natl Acad Sci U S A"},{"key":"ref14","volume-title":"[Updated 2022 Sep 26]. 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