Article
作者: Xiang, Feng ; Xu, Yuming ; Xiao, Lianchen ; Chen, Ting ; Wu, Lei ; Zhou, Hongyu ; Zhai, Feipeng ; Feng, Juan ; Deng, Bingmei ; Meng, Zhaoyou ; Wu, Zhe ; Li, Xiaofeng ; Fan, Weihao ; Meng, Qiang ; Zhu, Runxiu ; Meng, Li ; Li, Xiaoling ; Zhang, Qing ; Li, Feng ; Liu, Hong ; Chen, Junbin ; Wang, Zhe ; Liu, Sijun ; Zang, Weizhou ; Huang, Dehui ; Yang, Huan ; Li, Zunbo ; Qiu, Wei ; Liu, Xifang ; Wei, Min ; Meng, Huaxing ; Gu, Liangliang ; Qiu, Feng ; Zhang, Cun-Jin ; Gao, Feng ; Liang, Jinjin ; Dai, Tingjun ; Tian, Dai-Shi ; Li, Bin ; Duan, Ruisheng
Although CD20-directed B cell depletion has long been used in neuromyelitis optica spectrum disorder (NMOSD), high-quality, large-scale, randomized controlled trials remain limited. In this multicenter, randomized, double-blind phase 3 trial, we evaluated obinutuzumab β (MIL62), a novel glycoengineered type II anti-CD20 monoclonal antibody, in patients with NMOSD. Eligible participants aged 18-70 years with aquaporin-4-immunoglobulin G (AQP4-IgG)-seropositive NMOSD and an Expanded Disability Status Scale (EDSS) score of 7.0 or lower were randomly assigned (1:1) to receive intravenous obinutuzumab β 1,000 mg (n = 45) or placebo (n = 46). The primary outcome-time to first adjudicated relapse on or before week 52-was met: relapse occurred in two of 45 (4.4%) obinutuzumab β-treated participants and in 21 of 46 (45.7%) placebo-treated participants (hazard ratio = 0.069, 95% confidence interval: 0.016-0.296, P < 0.0001). The incidence of grade 3 or higher treatment-related adverse events was similar between the obinutuzumab β group (6.7%) and the placebo group (6.5%). These findings support obinutuzumab β as a glycoengineered type II anti-CD20 therapeutic option for patients with AQP4-IgG+ NMOSD. ClinicalTrials.gov identifier: NCT05314010 .