{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T15:34:19Z","timestamp":1787758459681,"version":"build-2784847793"},"reference-count":45,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Although there are a few options for the treatment of patients with secondary progressive multiple sclerosis (SPMS), rituximab (RTX) is used as an off-label treatment. This study aimed to investigate the efficacy of RTX on disability status and volumetric magnetic resonance imaging (MRI) findings in SPMS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>This study was conducted on 31 patients with SPMS treated with RTX 1000 mg intravenously every 6 months. Expanded Disability Status Scale (EDSS), 25-Foot Walk Test (25-FWT), 9-Hole Peg Test (9-HPT), and brain MRI were performed at the baseline and after 12 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      No significant changes were observed in EDSS, timed 25-FWT, and 9-HPT within 12 months of RTX treatment (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &gt; 0.05). There was a decrease in 9-HPT time in both the right and left hands, but it was not significant. During the 12-month assessment, white matter (WM) and gray matter volumes decreased by \u221241.48 \u00b1 2.36 and \u221231.65 \u00b1 8.84, respectively. However, these differences were not statistically significant (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &gt; 0.05). The only significant change was an increase in the volume of deep WM lesions (WMLs) (0.26 \u00b1 0.19 vs. 0.38 \u00b1 0.29,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.024). A significant association was found between the EDSS at the 12\n                      <jats:sup>th<\/jats:sup>\n                      month and baseline deep WML volume (\n                      <jats:italic toggle=\"yes\">r<\/jats:italic>\n                      = 0.383,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.044).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Our results showed that the level of disability based on EDSS, timed 25-FWT, and 9-HPT did not increase significantly during 12 months of treatment with RTX. These findings suggest that RTX may play a role in disease stabilization and preventing disability progression, especially in the upper limbs. Further studies with larger sample sizes are necessary to confirm this finding.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jrms.jrms_690_24","type":"journal-article","created":{"date-parts":[[2025,7,25]],"date-time":"2025-07-25T18:00:23Z","timestamp":1753466423000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Efficacy of rituximab in secondary progressive multiple sclerosis: Insights from magnetic resonance imaging and disability assessments"],"prefix":"10.4103","volume":"30","author":[{"given":"Fereshteh","family":"Ashtari","sequence":"first","affiliation":[{"name":"Department of Neurology, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yousef","family":"Mokary","sequence":"additional","affiliation":[{"name":"Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran"},{"name":"Student 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