Multiple sclerosis (S) is a condition that poses many diagnostic as well as therapeutic problems. Currently, there are two formulations of nonclonal antibodies directed against B lymphocytes (CD20) in development, which could be effective treatments, in the prodromal form of progressive multiple sclerosis. One of these is okrelizumab, which, after preliminary studies, has been shown to be more effective than placebo and interferon 1 - beta. The other is ofatumumab, which has been shown to be more effective than placebo. Each of these therapies had positive effects, which were confirmed by both radiological and clinical evidence, hence the question of the use of rituximab in the treatment of S.

Rituximab is already known to medicine and used in many therapies. It is registered as a therapeutic agent for the treatment of cancers that originate from B lymphocytes, rheumatoid arthritis, Wegener's granulomatosis or microscopic vasculitis. It is also used by neurologists for other conditions such as myasthenia gravis, autoimmune encephalitis, neuropathies or myopathies.

In Sweden, in 2016, there were two papers that documented the therapeutic effect of rituximab in S. One publication, concerned the confirmation of the efficacy of this substance in patients previously treated with natalizumab, where a better efficacy of rituximab was noted, while in the second publication, conclusions can be found from the use of rituximab in patients with the primary progressive form of S as well as with the projection-remission form. The study reported in the second publication also yielded results that demonstrate both clinical and radiological improvement in patients, moreover, it also showed its high safety.

Turning to the cost of therapy, where for interferon the expenditure is in the order of PLN 40,000 per year, so for rituximab the estimated price is around PLN 16,000 to PLN 30,000. This is therefore another argument for research into this substance to have the expected therapeutic effect. [1]