Eficacia del Rituximab como tratamiento de cuarta línea en pacientes con Miastenia Gravis Refractaria

Abstract

Refractory Myasthenia Gravis is a stage in which the patient presents exacerbation of symptoms, constant relapses, and, above all, therapeutic failure to conventional myasthenia gravis therapy. It is important to consider that the incidence is high in women between 20 and 30 years old. Therefore, analyzing the efficacy of the monoclonal antibody, Rituximab as a fourth-line treatment is relevant because it depends on its spectrum and adherence to include it in closer lines of treatment, as first or second, thinking about the quality of life of patients knowing that this disease is incurable. It is essential to know that, despite medical and therapeutic efforts, these patients experience symptoms persistence or worsening, which is a significant challenge for both patients and healthcare professionals. Rituximab in treating refractory myasthenia gravis has represented a critical milestone in the search for practical solutions for those patients who do not respond adequately to conventional therapies, significantly improving their health status even in the terminal stage. In Ecuador, therapeutic alternatives are based on cholinesterase inhibitors, corticosteroids, and immunosuppressive therapy. However, Rituxibam is not considered a conventional therapy for myasthenia gravis since it is not on the list of catastrophic, orphan, or rare diseases.