Hospital Practices and Research

Side Effects of Rituximab in Patients with Multiple Sclerosis

Document Type : Original Article

Authors

Hossein Pakdel 1
Masoud Etemadifar 2
Mahbubeh Mahnaee 3
Ali Foroughi 3

1 Department of Neurology, Shahid Beheshti University of Medical Sciences, Tehran, Iran

2 Department of Neurosurgery, Isfahan University of Medical Sciences, Isfahan, Iran

3 Isfahan University of Medical Sciences, Isfahan, Iran

https://doi.org/10.30491/hpr.2025.466437.1438
Abstract
Background: Multiple Sclerosis (MS) is the most common demyelinating inflammatory disease of the central nervous system. Rituximab is an anti-CD20 monoclonal antibody used as a primary drug for MS; however, it can cause injection and post-consumption side effects.
Objectives: This study aimed to determine the side effects of rituximab in patients with Multiple Sclerosis.
Methods: This descriptive-analytical study focused on MS patients who had received Rituximab and regularly visited Isfahan Multiple Sclerosis clinics in 2021. These patients had received at least two doses of Rituximab (1000 mg), and their symptoms and examinations were documented during face-to-face visits using checklists. The data were analyzed using SPSS version 22.
Results: In this study, 150 patients with MS participated. The number of attacks (more than one) before and after using Rituximab was 22% and 4.7%, respectively. The mean EDSS score among them before and after Rituximab was 3.53 ± 1.30 and 3.66 ± 1.51. 68.7% of the patients showed infusion side effects, such as a sore throat and dyspnea. Moreover, post-consumption side effects included muscle spasm, weight gain, arthralgia, and edema of the extremities.
Conclusion: The mean EDSS score before and after using Rituximab showed a slight increase, indicating no significant effects on improving dysfunctions, but the attack rate was reduced.

Keywords

Multiple Sclerosis
Rituximab
Side Effects
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