Real-World Multicenter Cohort Study of Inebilizumab vs Low-Dose Rituximab in Neuromyelitis Optica Spectrum Disorders
Journal: Neurology, Neuroimmunology & Neuroinflammation; April 27, 2026
Author(s): Qiao Xu, Linming Zhang, Xinyi Duan, Kai Zhou, Zhizhong Li, Xiaolin Yang, Jing Wang, Jinyu Jiang, Ke Xu, Gang Yu, Peng Zheng, Yongmei Li, Xinyue Qin, Jingyuan Li, Wen Ya Wang, He Zhao, Dehui Huang, Hao Qu, Haibing Xiao, Bin Li, Lei Wu, Jinzhou Feng
How effective is inebilizumab compared to low-dose rituximab for NMOSD?
This study aimed to compare the effectiveness and safety of inebilizumab versus rituximab (at a low dose of 500 mg) for NMOSD patients in actual clinical settings. The researchers used data from 229 patients with aquaporin 4 (AQP4) antibody-positive NMOSD from 6 cities in China.
Of the total patients, 119 were treated with inebilizumab and 110 with low-dose rituximab. Most of the patients (almost 95%) were female, and they were observed for 1 year on average. Relapses occurred in 8 of 119 (about 7%) patients receiving inebilizumab versus 24 of 110 (22%) patients receiving low-dose rituximab.
After accounting for differences between the groups, patients receiving low-dose rituximab were 4 times more likely to have an annual relapse than patients receiving inebilizumab.
In statistical terms, side effects occurred at a similar frequency in patients on both treatments. About 29% of people receiving inebilizumab and 40% receiving low-dose rituximab experienced at least one side effect known as an adverse event, but serious adverse events were uncommon in both groups.
Infections were less common among the patients receiving inebilizumab than those receiving low-dose rituximab.
Overall inebilizumab seemed more effective than rituximab at the dosage used in this study, but this result does not automatically translate to all doses of rituximab, and further research is needed.
Related article: Real-world multicentre cohort study on choices and effectiveness of immunotherapies in NMOSD and MOGAD
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