What is rituximab?
Rituximab is a monoclonal antibody that is approved for the treatment of ANCA associated vasculitis. Rituximab is sometimes used to treat other forms of vasculitis, such as cryoglobulinemia and urticarial vasculitis. There are several brands of Rituximab available, including Rituxan, Ruxience, and Truxima.
How does rituximab work?
Rituximab is designed to deplete B cells – white blood cells that make antibodies. Rituximab binds to a target called CD20 that is found on the surface of circulating B cells.
How is rituximab given?
Rituximab is given intravenously at an infusion center. Because allergic reactions can occur while the medication is being given, patients need to be monitored by nurses while receiving this drug.
For initial treatment of vasculitis, Rituximab is usually given once per week for 4 weeks. Sometimes, it may instead be given as 2 infusions separated by 2 weeks.
For maintenance treatment, Rituximab is usually given as one infusion every 6 months. Sometimes, the dosing interval can be lengthened to longer periods of time, such as 9 or 12 months.
We pay particular attention to the levels of total antibodies (immunoglobulins) over time when using this drug. In some scenarios, we may need to give supplemental immunoglobulin to patients whose antibody levels fall below normal levels.
Rituximab makes it difficult for the immune system to respond well to vaccines. This requires planning on the part of physician and patient to formulate a plan for the effective use of vaccines.
All immunosuppressants require regular monitoring in the form of blood tests, in-person assessments, and vigilance for signs of infection.