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Background: Rituximab is a chimeric monoclonal anti-CD20 B-cell-depleting antibody increasingly used off-label in multiple sclerosis (MS). The clinical relevance of anti-drug antibodies (ADAs) against rituximab in MS is unknown. Objective: To determine frequency of ADA in relation to B-cell counts, allergic reactions and clinical efficacy in a large cohort of MS-treated patients. Methods: Cross-sectional study with collection of serum samples from 339 MS patients immediately before a scheduled rituximab infusion. ADAs were detected using an in-house--validated electrochemiluminescent immunoassay and a commercial enzyme-linked immunosorbent assay (ELISA) to compare methods. Data on patient demographics and clinical outcomes were retrieved from the Swedish MS Registry and patient records. Results: ADAs were detected in 37% of relapsing--remitting MS and 26% in progressive forms of MS. Presence of ADAs decreased with increasing number of rituximab infusions. There was a significant association between both presence and titres of ADAs and incomplete B-cell depletion, but not with infusion/ adverse reactions or clinical outcomes at the group level. Only five patients terminated rituximab during follow-up, four of which were ADA positive. Conclusion: Rituximab treatment is associated with a high degree of ADAs, which correlates with efficacy of B-cell depletion; however, the clinical relevance of ADAs remains uncertain. [ABSTRACT FROM AUTHOR]

Conclusion: Patient self-administration of the Kinetic Oscillatory Stimulation (KOS)-catheter was a fully acceptable alternative to insertion of the catheter by physician with helmet fixation, in patients with non-allergic rhinitis (NAR). The approaches were equivalent regarding pain. The treatment effect in the patient self-administration group was not inferior. Objectives: To evaluate whether self-administration of a KOS-catheter was different compared to insertion by a physician, assessed with patient reported pain on a visual analogue scale (VAS). Also, to evaluate the difference in nasal stuffiness with the Sino-Nasal Outcome Test (SNOT-22) and Peak Nasal Inspiratory Flow (PNIF). Methods: Patients with NAR were randomized to group 1, patient insertion of catheter and manual fixation, and group 2, catheter insertion by physician and fixation with a helmet. Patients were treated once, 10 min in each nasal cavity, and followed up 14 days later. Results: Twenty-nine patients were included (group 1, n = 14; group 2, n = 15). There was no statistical significant difference in patient reported pain between groups. There was a decrease in nasal stuffiness after treatment in the total study population (n = 26, p = 0.001). In group 1 nasal stuffiness was decreased and in group 2 there was no change (group 1, p = 0.004; group 2, p = 0.071). No statistical significant change in PNIF was observed. [ABSTRACT FROM AUTHOR]