Rituximab in the treatment of multiple sclerosis in the Hospital District of Southwest Finland

BACKGROUND

There are already numerous B-cell depleting monoclonal anti-CD20 antibodies which have been used to reduce the inflammatory burden associated with multiple sclerosis (MS). We describe here our experience of treating MS-patients with B-cell depleting rituximab.

PATIENTS AND METHODS

All MS-patients (n = 72) who had received rituximab treatment for at least six months by January 2019 were identified from the patient charts at the Turku University Hospital. Information about MS disease subtype, disease severity, MR-imaging outcomes and B-cell counts were collected from the charts.

RESULTS

Rituximab was well received and well tolerated by the patients. There were no serious infusion-related side effects. The most serious adverse event that led to treatment discontinuation was neutropenia. After rituximab initiation the annual number of relapses was decreased in the relapsing remitting and secondary progressive MS groups and the mean number of gadolinium-enhancing lesions was decreased in relapsing remitting MS. Our study confirms the usability of rituximab treatment for MS in the Finnish health care environment.

CONCLUSIONS

Off-label rituximab-treatment can be successfully used to reduce MS disease burden for the benefit of MS patients.

Effects of XeCl excimer laser on the eyelid and anterior segment structures

We evaluated the in vitro and in vivo effects of an XeCl excimer laser on the eyelid and anterior segments of the eye. The wavelength of this laser was successfully transmitted through a quartz fiberoptic system. The action of the XeCl excimer laser through our system was more photocoagulative than photoablative.

Comparison of the effects of argon fluoride (ArF) and krypton fluoride (KrF) excimer lasers on ocular structures

We evaluated the effects of argon fluoride (ArF) and krypton fluoride (KrF) excimer lasers on ocular structures. We produced corneal incisions, optical iridotomy, capsulotomy, and retinotomy with these lasers. Incisions produced with ArF showed sharply defined borders with minimal coagulative effects to the adjacent structures. Cuts created with KrF showed coagulative necrosis of the wound edges ranging from two to five um in width. From our study it appears that ArF has photoablative action and KrF has a predominantly photoablative action with minimal photocoagulative effect on the tissue.