ĐÁNH GIÁ HIỆU QUẢ VÀ AN TOÀN CỦA RITUXIMAB TRONG RỐI LOẠN PHỔ VIÊM TỦY THỊ THẦN KINH TẠI BỆNH VIỆN NHÂN DÂN 115

Abstract

Objective: To develop a rituximab treatment protocol for NMOSD and to evaluate its feasibility, efficacy, and safety. Methods: We conducted a prospective case series involving five female patients with AQP4-IgG–positive NMOSD, diagnosed according to the 2015 IPND criteria, who were treated with rituximab at the Department of General Neurology, People’s Hospital 115, during the period from September 2024 to July 2025. Results: The protocol comprised assessment of indications and contraindications; laboratory testing and vaccination; the treatment regimen consisted of two 1 g infusions 14 days apart for induction, followed by 1 g every 6 months for maintenance; outpatient management. During 6 months of follow-up, no relapses were observed in any of the five patients. Two patients showed EDSS improvement (by 0.5 – 1 point), while three patients reduced their daily prednisolone dose (by 10 – 20 mg) and lost 3 – 6 kg in body weight. Regarding safety, three patients experienced no adverse events; two patients developed mild-to-moderate reactions (musculoskeletal pain, headache, flushing, dry skin). No serious adverse events or deaths were reported. Conclusion: The rituximab treatment protocol at People’s Hospital 115 achieved effective relapse prevention, functional improvement or stabilization, glucocorticoid dose reduction, and was both safe and feasible in clinical setting. Patients with AQP4-IgG-positive NMOSD should be considered for relapse-prevention therapy with rituximab.