Products
Rituximab is commercially available as a concentrate for the preparation of an infusion solution and as a solution for subcutaneous injection (MabThera, MabThera subcutaneous). It has been approved in many countries and in the United States since 1997 and in the EU since 1998. Biosimilars are available in some countries, including many (2018, Rixathon, Truxima, Ruxience). The MS drug ocrelizumab (Ocrevus, 2017) is closely related to rituximab.
Structure and properties
Rituximab is a chimeric (mouse/human) IgG1κ monoclonal antibody against CD20. It has a molecular mass of approximately 145 kD and is produced by biotechnological methods.
Effects
Rituximab (ATC L01XC02) selectively binds to the CD20 antigen on B lymphocytes and causes cell lysis, resulting in a decrease in the number of B cells. The mean half-life is in the range of approximately 29 days.
Indications
- Non-Hodgkin’s lymphoma
- Chronic lymphocytic leukemia
- Rheumatoid arthritis
- ANCA-associated vasculitis (AAV)
Dosage
According to the SmPC. The drugs are administered as intravenous infusion or subcutaneous injection.
Contraindications
- Hypersensitivity
- Severe heart failure
- Combination with chemotherapy including methotrexate during pregnancy and lactation.
Full precautions can be found in the drug label.
Adverse effects
Adverse effects depend on the route of administration, the drug, and the indication. The most common potential adverse effects include infusion reactions, infections, neutropenia, and gastrointestinal disturbances.