Rituximab is a monoclonal antibody currently being investigated as a potential therapy for multiple sclerosis.

Rituximab is an approved treatment for various types of blood cancer, and is marketed under the name Rituxan (in the U.S.) and MabThera (in Europe).

How rituximab works

Rituximab is a monoclonal antibody (a protein designed to target and attach to a specific protein) that interferes with the growth and spread of leukemia and lymphoma cancer cells. It works by targeting thee CD20 antigen, a substance found on the surface of certain immune cells called B-cells. Rituximab binds to the antigen on the cell surface which activates B-cell death. Because B-cells contribute to myelin damage in multiple sclerosis, rituximab may be helpful for treating the disease.

Studies involving rituximab for RRMS

Early studies of rituximab in people with neuromyelitis optica (NCT00501748) tested the drug’s safety. Although preliminary results from a group of eight people with neuromyelitis optica showed that B-cell depletion may enhance neurological recovery from attacks, there is still no published data from this study.

Rituximab has undergone other clinical studies in patients with different types of MS.

A Phase 2 study (NCT00097188) evaluated the safety and effectiveness of rituximab in adults with remitting-relapsing multiple sclerosis  (RRMS). Participants showed reduced numbers of new brain lesions and a 50% reduction in relapses.

A Phase 2/3 study (NCT00087529) evaluated the safety and effectiveness of rituximab in adults with primary progressive multiple sclerosis (PPMS). This trial compared rituximab to a placebo. Though rituximab did not prove effective, it was safe for people with PPMS.

A study (NCT01212094) involving people with secondary progressive multiple sclerosis (SPMS) was terminated because cerebrospinal fluid biomarkers failed to reach the criteria for continuation. This trial included 27 people with SPMS who received rituximab injections intrathecally (into the spine).

There are no Phase 3 trials currently planned for rituximab in MS, though the drug is licensed for other diseases and is currently used off-label for MS. Off-label use of rituximab for MS has received positive response — the observed annualized relapse rate and MRI disease activity were low during rituximab treatment, providing evidence that it is a safe and effective treatment for MS for up to 2 years. The compiled data for the outcome of off-label rituximab use in MS patients has been analysed and published in the scientific journal, Neurology.

Note: Multiple Sclerosis News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.


Rituximab Seen to Affect How B-cells Return After Treatment Stops

Rituximab, an investigational B-cell depletion therapy that target CD20 to treat people with multiple sclerosis (MS), has significant effects on the characteristics of B-cells that return after treatment is stopped, with cells being less mature yet more activated toward a pro-inflammatory state, a study showed. Treatment also affected immune system T-cells and myeloid cells.  Whether these […]

#MSVirtual2020 – Rituximab, Ocrevus Linked to Higher Risk of Worse COVID-19 Outcomes

The use of certain disease-modifying therapies (DMTs) such as rituximab and Ocrevus (ocrelizumab), which lower the number of a patient’s immune B-cells, may increase the odds of developing a more severe COVID-19 disease course for people with multiple sclerosis (MS), a study suggests. The study, which includes data from the largest group of patients with MS and COVID-19 currently available worldwide, […]

#MSVirtual2020 – Low Rituximab Doses Are Safer, as Effective as Higher Ones

Low doses of rituximab, an anti-inflammatory medication used off-label to treat multiple sclerosis (MS), are safer and as effective as higher doses at reducing the frequency of relapses and the number of MS lesions, a clinical study shows. The study findings were presented at MSVirtual2020 by Luciana Midaglia, MD, a neurologist from the Multiple Sclerosis […]

#MSVirtual2020 – GeNeuro’s Temelimab Found Safe When Given Alongside Rituximab

Temelimab, GeNeuro’s investigative treatment for multiple sclerosis (MS), showed a favorable safety profile when given alongside rituximab, according to preclinical safety experiments performed in preparation for the company’s new Phase 2 trial involving patients with relapsing MS. Data from the preclinical experiments, along with details of the new trial design, will be presented at the […]

Infection Risk Higher for Ocrevus Than Rituximab, But Cancer Risk Lower

Ocrevus (ocrelizumab), a second-generation anti-CD20 antibody, may be associated with a greater risk of infections. But it carries a lower risk of cancer and immune reactions than first-generation rituximab in people with multiple sclerosis (MS), according to a real-life study. The higher incidence of infections linked with Ocrevus’ use may result from a potentially different or more […]

Rituximab More Effective Than Gilenya, Tecfidera, and Comparable to Tysabri, Study Finds

Rituximab is more effective and leads to fewer treatment discontinuations in people with multiple sclerosis (MS) than Gilenya (fingolimod) and Tecfidera (dimethyl fumarate), according to real-world data based on two years of therapy. Rituximab’s effectiveness appeared to be comparable to that of Tysabri (natalizumab), but with fewer treatment discontinuations. These findings suggest that rituximab may be a […]

Rituximab May Prevent MS if Given at Earliest Disease Signs, Mouse Study Suggests

Using rituximab to prevent multiple sclerosis (MS) in people at risk or in patients still without motor symptoms, and continuing treatment as the disease develops, may be a promising way to avoid inflammation and myelin loss in the brain, a study in mice suggests. In an animal model of MS, this treatment approach significantly reduced clinical symptoms by […]

Biosimilar Truxima Works as Well as Rituximab Originator in MS, Study Finds

Truxima, a biosimilar of rituximab, is comparable to the originator therapy in terms of effectiveness and safety for treating multiple sclerosis (MS), a new study suggests. Rituximab — marketed as Rituxan in the United States — is an antibody-based therapy that works by killing B-cells, which are immune cells that drive inflammation in MS and other conditions. While not approved for MS […]

Gilenya Linked to Slightly Increased Cancer Risk in MS, Swedish Study Suggests

The risk of invasive cancer may be slightly higher in multiple sclerosis (MS) patients treated with Gilenya (fingolimod) compared with those treated with rituximab, and with people from the general population, a Swedish study suggests. The study, “Cancer Risk for Fingolimod, Natalizumab, and Rituximab in MS Patients,” was published in the journal Annals of Neurology. Disease-modifying […]