Background: and Purpose Treatments for neuromyelitis optica spectrum disorder (NMOSD) such as eculizumab, ravulizumab, satralizumab, and inebilizumab have significantly advanced relapse prevention, but they remain expensive. Rituximab is an off-label yet popular alternative that offers a cost-effective solution, but its real-world efficacy needs better quantification for guiding the application of newer approved NMOSD treatments (ANTs). This study aimed to determine real-world rituximab failure rates to anticipate the demand for ANTs and aid in resource allocation. Methods: We conducted a nationwide retrospective study involving 605 aquaporin-4-antibody-positive NMOSD patients from 22 centers in South Korea that assessed the efficacy and safety of rituximab over a median follow-up of 47 months. Results: The 605 patients treated with rituximab included 525 (87%) who received continuous therapy throughout the follow-up period (median=47 months, interquartile range=15–87 months). During this period, 117 patients (19%) experienced at least 1 relapse. Notably, 68 of these patients (11% of the total cohort) experienced multiple relapses or at least 1 severe relapse.Additionally, 2% of the patients discontinued rituximab due to adverse events, which included severe infusion reactions, neutropenia, and infections. Conclusions This study has confirmed the efficacy of rituximab in treating NMOSD, as evidenced by an 87% continuation rate among patients over a 4-year follow-up period. Nevertheless, the occurrence of at least one relapse in 19% of the cohort, including 11% who experienced multiple or severe relapses, and a 2% discontinuation rate due to adverse events highlight the urgent need for alternative therapeutic options.

Background: and Purpose Treatments for neuromyelitis optica spectrum disorder (NMOSD) such as eculizumab, ravulizumab, satralizumab, and inebilizumab have significantly advanced relapse prevention, but they remain expensive. Rituximab is an off-label yet popular alternative that offers a cost-effective solution, but its real-world efficacy needs better quantification for guiding the application of newer approved NMOSD treatments (ANTs). This study aimed to determine real-world rituximab failure rates to anticipate the demand for ANTs and aid in resource allocation. Methods: We conducted a nationwide retrospective study involving 605 aquaporin-4-antibody-positive NMOSD patients from 22 centers in South Korea that assessed the efficacy and safety of rituximab over a median follow-up of 47 months. Results: The 605 patients treated with rituximab included 525 (87%) who received continuous therapy throughout the follow-up period (median=47 months, interquartile range=15–87 months). During this period, 117 patients (19%) experienced at least 1 relapse. Notably, 68 of these patients (11% of the total cohort) experienced multiple relapses or at least 1 severe relapse.Additionally, 2% of the patients discontinued rituximab due to adverse events, which included severe infusion reactions, neutropenia, and infections. Conclusions This study has confirmed the efficacy of rituximab in treating NMOSD, as evidenced by an 87% continuation rate among patients over a 4-year follow-up period. Nevertheless, the occurrence of at least one relapse in 19% of the cohort, including 11% who experienced multiple or severe relapses, and a 2% discontinuation rate due to adverse events highlight the urgent need for alternative therapeutic options.

Background: and Purpose Treatments for neuromyelitis optica spectrum disorder (NMOSD) such as eculizumab, ravulizumab, satralizumab, and inebilizumab have significantly advanced relapse prevention, but they remain expensive. Rituximab is an off-label yet popular alternative that offers a cost-effective solution, but its real-world efficacy needs better quantification for guiding the application of newer approved NMOSD treatments (ANTs). This study aimed to determine real-world rituximab failure rates to anticipate the demand for ANTs and aid in resource allocation. Methods: We conducted a nationwide retrospective study involving 605 aquaporin-4-antibody-positive NMOSD patients from 22 centers in South Korea that assessed the efficacy and safety of rituximab over a median follow-up of 47 months. Results: The 605 patients treated with rituximab included 525 (87%) who received continuous therapy throughout the follow-up period (median=47 months, interquartile range=15–87 months). During this period, 117 patients (19%) experienced at least 1 relapse. Notably, 68 of these patients (11% of the total cohort) experienced multiple relapses or at least 1 severe relapse.Additionally, 2% of the patients discontinued rituximab due to adverse events, which included severe infusion reactions, neutropenia, and infections. Conclusions This study has confirmed the efficacy of rituximab in treating NMOSD, as evidenced by an 87% continuation rate among patients over a 4-year follow-up period. Nevertheless, the occurrence of at least one relapse in 19% of the cohort, including 11% who experienced multiple or severe relapses, and a 2% discontinuation rate due to adverse events highlight the urgent need for alternative therapeutic options.

Purpose: The aim of this study was to identify novel vaginal probiotics with the potential to prevent vulvovaginal candidiasis (VVC) and bacterial vaginosis (BV). Materials and Methods: Eighteen strains of Lactiplantibacillus plantarum were isolated from healthy Korean women, and their antimicrobial effects against Candida albicans and Gardnerella vaginalis were assessed. Three strains (L. plantarum LM1203, LM1209, and LM1215) were selected for further investigation, focusing on their growth inhibition, biofilm regulation, and cellular mechanisms against these vaginal pathogens. Additionally, electron microscopy revealed damage to G. vaginalis induced by L.plantarum LM1215, and genomic analysis was conducted on this strain. Results: L. plantarum LM1203, LM1209, and LM1215 showed approximately 1 and 2 Log CFU/mL growth reduction in C. albicans and G. vaginalis, respectively. These L. plantarum strains effectively inhibited biofilm formation and eliminated the mature biofilms formed by C. albicans. Furthermore, L. plantarum LM1215 decreased tricarboxylic acid cycle activity by 51.75 (p<0.001) and respiratory metabolic activity by 52.88% (p<0.001) in G. vaginalis. L. plantarum induced cellular membrane damage, inhibition of protein synthesis, and cell wall collapse in G. vaginalis. Genomic analysis confirmed L. plantarum LM1215 as a safe strain for vaginal probiotics. Conclusion The L. plantarum LM1215 is considered a safe probiotic agent suitable for the prevention of VVC and BV.

Purpose: The aim of this study was to identify novel vaginal probiotics with the potential to prevent vulvovaginal candidiasis (VVC) and bacterial vaginosis (BV). Materials and Methods: Eighteen strains of Lactiplantibacillus plantarum were isolated from healthy Korean women, and their antimicrobial effects against Candida albicans and Gardnerella vaginalis were assessed. Three strains (L. plantarum LM1203, LM1209, and LM1215) were selected for further investigation, focusing on their growth inhibition, biofilm regulation, and cellular mechanisms against these vaginal pathogens. Additionally, electron microscopy revealed damage to G. vaginalis induced by L.plantarum LM1215, and genomic analysis was conducted on this strain. Results: L. plantarum LM1203, LM1209, and LM1215 showed approximately 1 and 2 Log CFU/mL growth reduction in C. albicans and G. vaginalis, respectively. These L. plantarum strains effectively inhibited biofilm formation and eliminated the mature biofilms formed by C. albicans. Furthermore, L. plantarum LM1215 decreased tricarboxylic acid cycle activity by 51.75 (p<0.001) and respiratory metabolic activity by 52.88% (p<0.001) in G. vaginalis. L. plantarum induced cellular membrane damage, inhibition of protein synthesis, and cell wall collapse in G. vaginalis. Genomic analysis confirmed L. plantarum LM1215 as a safe strain for vaginal probiotics. Conclusion The L. plantarum LM1215 is considered a safe probiotic agent suitable for the prevention of VVC and BV.

Purpose: The aim of this study was to identify novel vaginal probiotics with the potential to prevent vulvovaginal candidiasis (VVC) and bacterial vaginosis (BV). Materials and Methods: Eighteen strains of Lactiplantibacillus plantarum were isolated from healthy Korean women, and their antimicrobial effects against Candida albicans and Gardnerella vaginalis were assessed. Three strains (L. plantarum LM1203, LM1209, and LM1215) were selected for further investigation, focusing on their growth inhibition, biofilm regulation, and cellular mechanisms against these vaginal pathogens. Additionally, electron microscopy revealed damage to G. vaginalis induced by L.plantarum LM1215, and genomic analysis was conducted on this strain. Results: L. plantarum LM1203, LM1209, and LM1215 showed approximately 1 and 2 Log CFU/mL growth reduction in C. albicans and G. vaginalis, respectively. These L. plantarum strains effectively inhibited biofilm formation and eliminated the mature biofilms formed by C. albicans. Furthermore, L. plantarum LM1215 decreased tricarboxylic acid cycle activity by 51.75 (p<0.001) and respiratory metabolic activity by 52.88% (p<0.001) in G. vaginalis. L. plantarum induced cellular membrane damage, inhibition of protein synthesis, and cell wall collapse in G. vaginalis. Genomic analysis confirmed L. plantarum LM1215 as a safe strain for vaginal probiotics. Conclusion The L. plantarum LM1215 is considered a safe probiotic agent suitable for the prevention of VVC and BV.

Purpose: The aim of this study was to identify novel vaginal probiotics with the potential to prevent vulvovaginal candidiasis (VVC) and bacterial vaginosis (BV). Materials and Methods: Eighteen strains of Lactiplantibacillus plantarum were isolated from healthy Korean women, and their antimicrobial effects against Candida albicans and Gardnerella vaginalis were assessed. Three strains (L. plantarum LM1203, LM1209, and LM1215) were selected for further investigation, focusing on their growth inhibition, biofilm regulation, and cellular mechanisms against these vaginal pathogens. Additionally, electron microscopy revealed damage to G. vaginalis induced by L.plantarum LM1215, and genomic analysis was conducted on this strain. Results: L. plantarum LM1203, LM1209, and LM1215 showed approximately 1 and 2 Log CFU/mL growth reduction in C. albicans and G. vaginalis, respectively. These L. plantarum strains effectively inhibited biofilm formation and eliminated the mature biofilms formed by C. albicans. Furthermore, L. plantarum LM1215 decreased tricarboxylic acid cycle activity by 51.75 (p<0.001) and respiratory metabolic activity by 52.88% (p<0.001) in G. vaginalis. L. plantarum induced cellular membrane damage, inhibition of protein synthesis, and cell wall collapse in G. vaginalis. Genomic analysis confirmed L. plantarum LM1215 as a safe strain for vaginal probiotics. Conclusion The L. plantarum LM1215 is considered a safe probiotic agent suitable for the prevention of VVC and BV.