Rituximab Linked to Higher IBD Risk Than Other MS Therapies

A Swedish population-based cohort study compared new-onset inflammatory bowel disease (IBD) across rituximab, natalizumab, dimethyl fumarate, and fingolimod in patients with relapsing-remitting multiple sclerosis. The study reported a crude IBD incidence of 110 per 100,000 person-years with rituximab versus 13 for comparator DMTs and 41 in the general population, with an adjusted hazard ratio of 0.10 (95% CI, 0.04-0.22) for comparator DMTs versus rituximab and a number needed to harm of 131 at 5 years; 62% of IBD events in the rituximab group were classified as Crohn disease compared with 29% in the general population. The authors concluded that rituximab was associated with increased IBD risk relative to other modern MS therapies after adjustment for baseline differences.

Most relevant for: Patients with relapsing-remitting multiple sclerosis being treated with or considered for anti-CD20 therapy such as rituximab.

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