2026 American Academy of Neurology Abstract Website

Objective:

To evaluate the clinical response and tolerability of Rituximab in CNS demyelinating disorders over a nine-year period.

Background:

Rituximab and demyelinating diseases have been studied extensively in multiple-sclerosis (MS) centers worldwide, yet regional data from low- and middle-income countries remain limited. In Pakistan, where disease-modifying therapies are often unaffordable, early recognition and timely treatment can reduce long-term disability. This study presents real-world experience from a tertiary academic center providing integrated neurological and immunologic care for patients with demyelinating disorders of the central nervous system (CNS).

Design/Methods:

A retrospective single-center review was conducted of patients who received Rituximab between 2017 and 2025. After Ethical Review Board approval, data were collected in a standardized format, excluding patients with peripheral nervous disorders. Statistical analysis was performed using SPSS v22.

Results:

A total of 139 patients were included (mean age 31.8 ± 9.6 years; 54 % female). Diagnoses comprised MS (≈ 60 %), NMOSD (≈ 14 %), and CRION (1 patient, 0.7 %). The mean number of Rituximab doses was 5 (± 1.7; range 1–12). Most patients [8.2%] improved after three doses, while 2 % did not respond. Mild infusion reactions (itching, transient blood-pressure rise, sore throat) occurred in ≈ 10 %; no serious events were observed. About 60 % remained in active follow-up, 11 % were lost, and four deaths were unrelated to therapy.

Conclusions:

Rituximab was effective and well tolerated in this cohort. Experience from the Sindh Institute of Urology & Transplantation (SIUT) underscores its feasibility and value as a cost-effective option for early disease control and disability prevention in resource-limited settings, contributing regional data to global evidence on B-cell-directed therapy.