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Hypogammaglobulinae...
Hypogammaglobulinaemia during rituximab treatment in multiple sclerosis : a Swedish cohort study
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- Hallberg, Susanna (författare)
- Department of Clinical Sciences, Karolinska Institutet, Danderyds Sjukhus, Stockholm, Sweden
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- Evertsson, Björn (författare)
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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- Lillvall, Ellen (författare)
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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- Boremalm, Malin (författare)
- Umeå universitet,Neurovetenskaper
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- de Flon, Pierre, 1966- (författare)
- Umeå universitet,Neurovetenskaper
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- Wang, Yunzhang (författare)
- Department of Clinical Sciences, Karolinska Institutet, Danderyds Sjukhus, Stockholm, Sweden
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- Salzer, Jonatan (författare)
- Umeå universitet,Neurovetenskaper
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- Lycke, Jan (författare)
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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- Fink, Katharina (författare)
- Karolinska Institutet
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- Frisell, Thomas (författare)
- Karolinska Institutet
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- Al Nimer, Faiez (författare)
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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- Svenningsson, Anders (författare)
- Karolinska Institutet
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(creator_code:org_t)
- John Wiley & Sons, 2024
- 2024
- Engelska.
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Ingår i: European Journal of Neurology. - : John Wiley & Sons. - 1351-5101 .- 1468-1331. ; 31:8
- Relaterad länk:
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https://doi.org/10.1...
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https://umu.diva-por... (primary) (Raw object)
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https://urn.kb.se/re...
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https://doi.org/10.1...
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http://kipublication...
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Abstract
Ämnesord
Stäng
- Background and purpose: Mechanisms behind hypogammaglobulinaemia during rituximab treatment are poorly understood.Methods: In this register-based multi-centre retrospective cohort study of multiple sclerosis (MS) patients in Sweden, 2745 patients from six participating Swedish MS centres were identified via the Swedish MS registry and included between 14 March 2008 and 25 January 2021. The exposure was treatment with at least one dose of rituximab for MS or clinically isolated syndrome, including data on treatment duration and doses. The degree of yearly decrease in immunoglobulin G (IgG) and immunoglobulin M (IgM) levels was evaluated.Results: The mean decrease in IgG was 0.27 (95% confidence interval 0.17–0.36) g/L per year on rituximab treatment, slightly less in older patients, and without significant difference between sexes. IgG or IgM below the lower limit of normal (<6.7 or <0.27 g/L) was observed in 8.8% and 8.3% of patients, respectively, as nadir measurements. Six out of 2745 patients (0.2%) developed severe hypogammaglobulinaemia (IgG below 4.0 g/L) during the study period. Time on rituximab and accumulated dose were the main predictors for IgG decrease. Previous treatment with fingolimod and natalizumab, but not teriflunomide, dimethyl fumarate, interferons or glatiramer acetate, were significantly associated with lower baseline IgG levels by 0.80–1.03 g/L, compared with treatment-naïve patients. Switching from dimethyl fumarate or interferons was associated with an additional IgG decline of 0.14–0.19 g/L per year, compared to untreated.Conclusions: Accumulated dose and time on rituximab treatment are associated with a modest but significant decline in immunoglobulin levels. Previous MS therapies may influence additional IgG decline.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Neurologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Neurology (hsv//eng)
Nyckelord
- disease-modifying therapy
- hypogammaglobulinaemia
- IgG decrease
- IgM decrease
- immunoglobulin decrease
- multiple sclerosis
- real-world data
- rituximab therapy
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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Till lärosätets databas
- Av författaren/redakt...
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Hallberg, Susann ...
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Evertsson, Björn
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Lillvall, Ellen
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Boremalm, Malin
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de Flon, Pierre, ...
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Wang, Yunzhang
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visa fler...
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Salzer, Jonatan
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Lycke, Jan
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Fink, Katharina
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Frisell, Thomas
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Al Nimer, Faiez
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Svenningsson, An ...
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visa färre...
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Umeå universitet
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Karolinska Institutet