Immunoglobulin-G dynamics and relation to antibiotic prescriptions in multiple sclerosis patients treated with rituximab: a real-world cohort

Rituximab treatment resulted in a significant, dose-dependent IgG decline. However, this decline was not associated with an increased risk of antibiotic-treated infections, suggesting a dissociation between total IgG levels and functional immune competence in this cohort. These findings support continued use of rituximab with vigilant monitoring, though dose adjustments may be warranted for patients with rapidly decreasing IgG.