Rituximab Print Page

What is Rituximab?

  • Rituximab is a biologic, a newer class of DMARD (Disease Modifying Anti-Rheumatic Drug).
  • While in the same class as TNF antagonists, Rituximab does not work in the same way.
  • Rituximab is primarily used in the treatment of inflammatory arthritis such as rheumatoid arthritis, but has also been used to treat a variety of other rheumatic autoimmune diseases.

What is the typical dose?  How often do you take them?

  • Rituximab is typically given through an intravenous infusion twice, 2 weeks apart, at a dose of 1000mg.  It is usually re-administered between 6-12 months later, depending on its effectiveness.

How does Rituximab work?

  • The immune system is made up of many different parts.  By interfering with the correct part, it is possible to decrease the inflammation being caused by rheumatoid arthritis and similar diseases.  Rituximab binds a molecule on the surface of B cells, blocking their action and modulating the immune system’s response.

 What are B cells?  Don’t I need them to work?

  • B cells are an important part of the body’s immune system, including making antibodies to fight infections.  Rituximab binds CD20, a molecule on most B cells, but not ones that are immature or fully matured.  By targeting this specific part of B cells, it allows the immune system to be mildly suppressed while allowing the medication to control your autoimmune condition.

How soon will I feel the effects of Rituximab?

  • Rituximab can take at least 3-4 months before starting to gain benefit.

If I start Rituximab, can I stop all my other DMARDs?

  • Most rheumatologists will suggest you continue with at least methotrexate.  Studies have shown that most Biologics, including Rituximab, work significantly better when combined with methotrexate.
  • Keep in mind: In most instances, your rheumatologist has recommended you start a Biologic because your inflammatory arthritis has not been well controlled.  It is important to try to control your disease as best as possible first, which may mean continuing all DMARDs for some time, before trying to decrease them.

What are the possible side effects of Rituximab?

  • Intravenous Infusion Reactions
  • Rituximab may increase your risk of developing severe infections, particularly lung infections
  • Skin Reactions
  • Viral Hepatitis

Is there a way to reduce the risk of side effects?

  • Let your physician know if you are sick when you are supposed to receive your infusion.  They may discuss postponing your infusion until you are better.
  • Fevers and other severe illness should not be ignored.  Discuss this with your doctor.
  • Tell your doctor if notice any skin changes even a few weeks after your infusion.
  • Let your doctor know if you have ever been diagnosed with hepatitis, or take medications for high blood pressure.
  • Live vaccines should be avoided when taking Rituximab.

What should I do if I miss a dose?

  • If you miss your dose, let your physician know right away to arrange a new infusion time, if appropriate to do so..

 

 

For more information about Rituximab, visit AlbertaRheumatology.com and consult your physician.