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Background: Azathioprine (AZA) and rituximab (RTX) are frequently used drugs in the treatment of Myelin Oligodendrocyte Glycoprotein Associated Disease (MOGAD).
Objectives: The aim of this study was to evaluate the efficacy and safety data of AZA and RTX treatments in MOGAD.
Methods: Patients diagnosed according to the 2023 MOGAD diagnostic criteria and receiving AZA or RTX treatment were included in the study.
Results: In 142 patients included in the study, the female/male value was 1.2. The rate of OCB positivity in MOGAD patients was 22.6 %. Patients on RTX had higher EDSS values than patients on AZA. However, the RTX group demonstrated a more pronounced improvement in disability, reflected by a greater negative trend in the ΔEDSS values. The attack-free rate was 78 % in the RTX group and 68 % in the AZA group during their treatment period. Both groups had no difference in the time of the first attack. The main factor affecting the time to first attack was having a higher EDSS at the time of treatment initiation. The survival analysis found that EDSS scores improved significantly in patients treated with RTX.
Conclusion: Although survival analyses for both treatments appear to be similar, using RTX provides better EDSS scores.
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http://dx.doi.org/10.1016/j.jneuroim.2025.578686 | DOI Listing |
Clin Exp Rheumatol
September 2025
Department of Rheumatology and Clinical Immunology, University of Lübeck, Germany.
Objectives: This retrospective cohort study aimed to evaluate real-world data on the efficacy of rituximab (RTX) alone versus combined rituximab/cyclophosphamide (RTX/CYC) induction therapy, followed by RTX maintenance, compared with cyclophosphamide-azathioprine (CYC-AZA) therapy in ANCA-associated vasculitis (AAV).
Methods: Patients with new-onset or relapsing organ- or life-threatening AAV (granulomatosis with polyangiitis [GPA] n=97; microscopic polyangiitis [MPA], n=69) were followed over 24-months. Patients with previous RTX and/or CYC therapy were excluded.
Caspian J Intern Med
June 2025
Department of Internal Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Background: Granulomatosis with polyangiitis (GPA) is a rare disease affecting medium-small vessels, causing granuloma formation and inflammation. This study aimed to assess the efficacy and safety of RTX versus Azathioprine (AZA) for maintenance treatment in GPA patients.
Methods: This retrospective cohort study involved a review of medical records of recently diagnosed GPA patients undergoing maintenance treatment with RTX or AZA.
J Neuroimmunol
October 2025
Hacettepe University Faculty of Medicine, Department of Neurology, Ankara, Türkiye. Electronic address:
Background: Azathioprine (AZA) and rituximab (RTX) are frequently used drugs in the treatment of Myelin Oligodendrocyte Glycoprotein Associated Disease (MOGAD).
Objectives: The aim of this study was to evaluate the efficacy and safety data of AZA and RTX treatments in MOGAD.
Methods: Patients diagnosed according to the 2023 MOGAD diagnostic criteria and receiving AZA or RTX treatment were included in the study.
Front Immunol
June 2025
Tianjin Children's Hospital (Tianjin University Children's Hospital), Tianjin, China.
Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD) is a rare acquired demyelinating syndrome manifesting as optic neuritis (ON), transverse myelitis (TM), acute disseminated encephalomyelitis (ADEM), and brainstem encephalitis. The disease is characterized by serum autoantibodies targeting myelin oligodendrocyte glycoprotein (MOG), which is exclusively expressed on central nervous system (CNS) myelin and oligodendrocyte membranes. Experimental autoimmune encephalomyelitis (EAE) models have been instrumental in elucidating how these antibodies trigger complement-dependent cytotoxicity (CDC) and antibody-dependent cellular responses, leading to inflammatory demyelination.
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April 2025
Department of Neurology, First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Background And Purpose: Biologic therapies are anticipated to dominate the treatment landscape for neuromyelitis optica spectrum disorders (NMOSD) in the future. Despite this, many patients in China continue to use off-label medications due to economic and other constraints. A multicenter NMOSD cohort study was conducted to compare the efficacy and safety of tacrolimus (TAC), mycophenolate mofetil (MMF), azathioprine (AZA), and rituximab (RTX).
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