Difference between revisions of "Rituximab (Rituxan)"
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==Diseases for which it is used== | ==Diseases for which it is used== | ||
<div style="column-count:3;-moz-column-count:3;-webkit-column-count:3"> | <div style="column-count:3;-moz-column-count:3;-webkit-column-count:3"> | ||
| − | *[[Acquired | + | *[[Acquired hemophilia A]] |
| − | *[[Immune thrombocytopenia | + | *[[Acquired thrombotic thrombocytopenic purpura]] |
| + | *[[Immune thrombocytopenia]] | ||
*[[B-cell acute lymphoblastic leukemia]] | *[[B-cell acute lymphoblastic leukemia]] | ||
*[[B-cell lymphoma of mucosa-associated lymphoid tissue]] | *[[B-cell lymphoma of mucosa-associated lymphoid tissue]] | ||
| Line 25: | Line 26: | ||
*[[Cold agglutinin disease]] | *[[Cold agglutinin disease]] | ||
*[[Hairy cell leukemia]] | *[[Hairy cell leukemia]] | ||
| + | *[[High-grade B-cell lymphoma]] | ||
*[[HIV-associated lymphoma]] | *[[HIV-associated lymphoma]] | ||
| − | *[[Hodgkin lymphoma]] | + | *[[Classical Hodgkin lymphoma]] |
*[[Hodgkin lymphoma, nodular lymphocyte-predominant]] | *[[Hodgkin lymphoma, nodular lymphocyte-predominant]] | ||
*[[Inherited coagulopathy|Inherited coagulopathy with inhibitor]] | *[[Inherited coagulopathy|Inherited coagulopathy with inhibitor]] | ||
| Line 33: | Line 35: | ||
*[[Post-transplant lymphoproliferative disorder]] | *[[Post-transplant lymphoproliferative disorder]] | ||
*[[Primary mediastinal B-cell lymphoma]] | *[[Primary mediastinal B-cell lymphoma]] | ||
| − | *[[ | + | *[[Acquired thrombotic thrombocytopenic purpura]] |
*[[Transformed lymphoma]] | *[[Transformed lymphoma]] | ||
| + | *[[Warm autoimmune hemolytic anemia]] | ||
</div> | </div> | ||
==Patient drug information== | ==Patient drug information== | ||
*[http://www.gene.com/gene/products/information/pdf/rituxan-prescribing.pdf Rituximab (Rituxan) package insert]<ref name="insert"></ref> | *[http://www.gene.com/gene/products/information/pdf/rituxan-prescribing.pdf Rituximab (Rituxan) package insert]<ref name="insert"></ref> | ||
| − | *[https://chemocare.com/ | + | *[https://chemocare.com/druginfo/Rituximab.aspx Rituximab (Rituxan) patient drug information (Chemocare)]<ref>[https://chemocare.com/druginfo/Rituximab.aspx Rituximab (Rituxan) patient drug information (Chemocare)]</ref> |
*[http://www.uptodate.com/contents/rituximab-patient-drug-information Rituximab (Rituxan) patient drug information (UpToDate)]<ref>[http://www.uptodate.com/contents/rituximab-patient-drug-information Rituximab (Rituxan) patient drug information (UpToDate)]</ref> | *[http://www.uptodate.com/contents/rituximab-patient-drug-information Rituximab (Rituxan) patient drug information (UpToDate)]<ref>[http://www.uptodate.com/contents/rituximab-patient-drug-information Rituximab (Rituxan) patient drug information (UpToDate)]</ref> | ||
==History of changes in FDA dosing recommendations== | ==History of changes in FDA dosing recommendations== | ||
| − | *10 | + | *2012-10-19: Approved for 90-minute infusion in previously untreated [[Diffuse large B-cell lymphoma| diffuse large B-cell lymphoma (DLBCL)]] and [[Follicular lymphoma | follicular Non-Hodgkin lymphoma (NHL)]] starting with cycle 2:<ref>[http://www.hematology.org/News/2012/9119.aspx FDA Approves New Dosing and Administration Information for Rituximab (2012-10-19)] Hematology.org, accessed 2012-10-19</ref> |
| − | **Patients who do not experience a grade 3 or 4 infusion related adverse event during cycle 1 may undergo a 90-minute infusion when used as part of a glucocorticoid-containing chemotherapy regimen. In cycle 2, 20% of the total dose is to be given over the first 30 minutes, and the remaining 80% of the total dose is to be given over the last 60 minutes. If this 90-minute infusion is tolerated, the same rate can be used for remaining cycles of the treatment.<ref name="insert"></ref><ref>Atmar J. Review of the safety and feasibility of rapid infusion of rituximab. J Oncol Pract. 2010 Mar;6(2):91-3. [https://doi.org/10.1200/jop.200001 link to original article] '''contains dosing details in manuscript''' [https://www.ncbi.nlm.nih.gov/pmc/articles/pmc2835489/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/20592783/ PubMed]</ref><ref>Sehn LH, Donaldson J, Filewich A, Fitzgerald C, Gill KK, Runzer N, Searle B, Souliere S, Spinelli JJ, Sutherland J, Connors JM. Rapid infusion rituximab in combination with corticosteroid-containing chemotherapy or as maintenance therapy is well tolerated and can safely be delivered in the community setting. Blood. 2007 May 15;109(10):4171-3. Epub 2007 Jan 23. [http://www.bloodjournal.org/content/109/10/4171.full.html link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/17244675/ PubMed]</ref><ref>Dakhil S, Hermann R, Schreeder MT, Gregory SA, Monte M, Windsor KS, Hurst D, Chai A, Brewster M, Richards P. Phase III safety study of rituximab administered as a 90-minute infusion in patients with previously untreated diffuse large B-cell and follicular lymphoma. Leuk Lymphoma. 2014 Oct;55(10):2335-40. Epub 2014 Mar 7. [https://pubmed.ncbi.nlm.nih.gov/24471908 PubMed]</ref> | + | **Patients who do not experience a grade 3 or 4 infusion related adverse event during cycle 1 may undergo a 90-minute infusion when used as part of a glucocorticoid-containing chemotherapy regimen. In cycle 2, 20% of the total dose is to be given over the first 30 minutes, and the remaining 80% of the total dose is to be given over the last 60 minutes. If this 90-minute infusion is tolerated, the same rate can be used for remaining cycles of the treatment.<ref name="insert"></ref><ref>Atmar J. Review of the safety and feasibility of rapid infusion of rituximab. J Oncol Pract. 2010 Mar;6(2):91-3. [https://doi.org/10.1200/jop.200001 link to original article] '''contains dosing details in manuscript''' [https://www.ncbi.nlm.nih.gov/pmc/articles/pmc2835489/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/20592783/ PubMed]</ref><ref>Sehn LH, Donaldson J, Filewich A, Fitzgerald C, Gill KK, Runzer N, Searle B, Souliere S, Spinelli JJ, Sutherland J, Connors JM. Rapid infusion rituximab in combination with corticosteroid-containing chemotherapy or as maintenance therapy is well tolerated and can safely be delivered in the community setting. Blood. 2007 May 15;109(10):4171-3. Epub 2007 Jan 23. [http://www.bloodjournal.org/content/109/10/4171.full.html link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/17244675/ PubMed]</ref><ref>Dakhil S, Hermann R, Schreeder MT, Gregory SA, Monte M, Windsor KS, Hurst D, Chai A, Brewster M, Richards P. Phase III safety study of rituximab administered as a 90-minute infusion in patients with previously untreated diffuse large B-cell and follicular lymphoma. Leuk Lymphoma. 2014 Oct;55(10):2335-40. Epub 2014 Mar 7. [https://pubmed.ncbi.nlm.nih.gov/24471908/ PubMed]</ref> |
==History of changes in FDA indication== | ==History of changes in FDA indication== | ||
''Note: there is a gap in FDA labels between 1997 and 2006 on the FDA website; there are likely missing indications issued during that time period.'' | ''Note: there is a gap in FDA labels between 1997 and 2006 on the FDA website; there are likely missing indications issued during that time period.'' | ||
===[[Chronic lymphocytic leukemia]]=== | ===[[Chronic lymphocytic leukemia]]=== | ||
| − | * | + | *2010-02-18: Approved in combination with fludarabine and cyclophosphamide (FC), for the treatment of previously untreated and previously treated patients with [[Chronic lymphocytic leukemia|chronic lymphocytic leukemia (CLL)]]. ''(New disease entity; based on GCLLSG CLL8 & REACH)'' |
===[[Diffuse large B-cell lymphoma]]=== | ===[[Diffuse large B-cell lymphoma]]=== | ||
| − | * | + | *2006-02-10: Approved for use in the first-line treatment of patients with [[Diffuse large B-cell lymphoma|diffuse large B-cell]], [[Biomarkers#CD20|CD20]]-[[Biomarkers#Expression|positive]], non-Hodgkin's lymphoma in combination with CHOP or other anthracycline-based chemotherapy regimens. ''(new disease entity added; scope expanded to first-line treatment; combination therapy required; based on ECOG E4494, LNH 98-5, NCIC-CTG LY.9)'' |
===[[Follicular lymphoma]]=== | ===[[Follicular lymphoma]]=== | ||
| − | *11 | + | *1997-11-26: Initial FDA approval for the treatment of patients with relapsed or refractory [[Follicular lymphoma |follicular]], [[Biomarkers#CD20|CD20]] [[Biomarkers#Expression|positive]], B-cell non-Hodgkin’s lymphoma. ''(Based on Maloney et al. 1997a & McLaughlin et al. 1998)'' |
| − | * | + | *2006-09-29: Approved for the first-line treatment of patients with [[Follicular lymphoma |follicular]], [[Biomarkers#CD20|CD20]]-[[Biomarkers#Expression|positive]] B-cell non-Hodgkin’s lymphoma. ''(scope expanded to first-line treatment; based on M39021)'' |
| − | * | + | *2011-01-28: Approved for maintenance therapy for patients with previously untreated [[Follicular lymphoma |follicular]], [[Biomarkers#CD20|CD-20]] [[Biomarkers#Expression|positive]], B-cell non-Hodgkin lymphoma who achieve a response to rituximab in combination with chemotherapy. ''(Approval extended to maintenance setting; based on ECOG E1496 & PRIMA<sub>FL</sub>) |
===[[:Category:Indolent lymphomas|Indolent (Low grade) lymphoma]]=== | ===[[:Category:Indolent lymphomas|Indolent (Low grade) lymphoma]]=== | ||
| − | *11 | + | *1997-11-26: Initial FDA approval for the treatment of patients with relapsed or refractory [[:Category:Indolent lymphomas|low-grade]], [[Biomarkers#CD20|CD20]] [[Biomarkers#Expression|positive]], B-cell non-Hodgkin’s lymphoma. ''(Based on Maloney et al. 1997a & McLaughlin et al. 1998)'' |
| − | * | + | *2006-09-29: Approved for the first-line treatment of patients with [[:Category:Indolent lymphomas|low grade]], [[Biomarkers#CD20|CD20]]-[[Biomarkers#Expression|positive]] B-cell non-Hodgkin’s lymphoma. ''(scope expanded to first-line treatment; based on M39021)'' |
===[[Non-Hodgkin lymphoma, pediatric|Pediatric lymphoma/leukemia]]=== | ===[[Non-Hodgkin lymphoma, pediatric|Pediatric lymphoma/leukemia]]=== | ||
| − | *12 | + | *2021-12-02: Approved in combination with chemotherapy for pediatric patients (at least 6 months to less than 18 years) with previously untreated, advanced stage, [[Biomarkers#CD20|CD20]]-[[Biomarkers#Expression|positive]] [[Non-Hodgkin lymphoma, pediatric|diffuse large B-cell lymphoma (DLBCL), Burkitt lymphoma (BL), Burkitt-like lymphoma (BLL), or mature B-cell acute leukemia (B-AL)]]. ''(Based on Inter-B-NHL Ritux 2010)'' |
==History of changes in EMA indication== | ==History of changes in EMA indication== | ||
| − | * | + | *1998-06-02: Initial marketing authorization as MabThera. |
| + | ==History of changes in PMDA indication== | ||
| + | *2013-06-14: New additional indication and a new dosage for the treatment of CD 20-positive B-cell lymphoproliferative disorders in immunocompromised patients. | ||
| + | *2017-06-26: New additional indication and a new dosage for the treatment of chronic [[Immune thrombocytopenia|idiopathic thrombocytopenic purpura]]. | ||
| + | *2019-03-26: New additional indication and a new dosage for the treatment of CD20-positive [[chronic lymphocytic leukemia]]. | ||
| + | *2020-02-21: New indication and a new dosage for the treatment of [[acquired thrombotic thrombocytopenic purpura]]. | ||
==Also known as== | ==Also known as== | ||
| − | *'''Code names:''' BI 695500, IDEC-102, IDEC-C2B8, | + | *'''Code names:''' BI-695500, IDEC-102, IDEC-C2B8, RTXM-83 |
*'''Brand names:''' Ikgdar, Mabtas, MabThera, Reditux, Ristova, Rituxan, Rituxim, Transera-Kit | *'''Brand names:''' Ikgdar, Mabtas, MabThera, Reditux, Ristova, Rituxan, Rituxim, Transera-Kit | ||
| Line 82: | Line 90: | ||
[[Category:Anti-CD20 antibodies]] | [[Category:Anti-CD20 antibodies]] | ||
| − | [[Category:Acquired | + | [[Category:Acquired hemophilia A medications]] |
| + | [[Category:Acquired thrombotic thrombocytopenic purpura medications]] | ||
[[Category:B-cell acute lymphoblastic leukemia medications]] | [[Category:B-cell acute lymphoblastic leukemia medications]] | ||
[[Category:Burkitt lymphoma medications]] | [[Category:Burkitt lymphoma medications]] | ||
| Line 92: | Line 101: | ||
[[Category:Follicular lymphoma medications]] | [[Category:Follicular lymphoma medications]] | ||
[[Category:Hairy cell leukemia medications]] | [[Category:Hairy cell leukemia medications]] | ||
| + | [[Category:High-grade B-cell lymphoma medications]] | ||
[[Category:HIV-associated lymphoma medications]] | [[Category:HIV-associated lymphoma medications]] | ||
| − | [[Category:Hodgkin lymphoma medications]] | + | [[Category:Classical Hodgkin lymphoma medications]] |
[[Category:Hodgkin lymphoma, nodular lymphocyte-predominant medications]] | [[Category:Hodgkin lymphoma, nodular lymphocyte-predominant medications]] | ||
[[Category:Immune thrombocytopenia medications]] | [[Category:Immune thrombocytopenia medications]] | ||
| Line 103: | Line 113: | ||
[[Category:Post-transplant lymphoproliferative disorder medications]] | [[Category:Post-transplant lymphoproliferative disorder medications]] | ||
[[Category:Primary mediastinal B-cell lymphoma medications]] | [[Category:Primary mediastinal B-cell lymphoma medications]] | ||
| − | [[Category: | + | [[Category:Acquired thrombotic thrombocytopenic purpura medications]] |
[[Category:Transformed lymphoma medications]] | [[Category:Transformed lymphoma medications]] | ||
[[Category:Waldenström macroglobulinemia medications]] | [[Category:Waldenström macroglobulinemia medications]] | ||
| + | [[Category:Warm autoimmune hemolytic anemia medications]] | ||
[[Category:EMA approved in 1998]] | [[Category:EMA approved in 1998]] | ||
Latest revision as of 12:55, 26 May 2024
General information
Class/mechanism: Anti-CD20 antibody, chimeric murine/human monoclonal IgG1 kappa, which binds to CD20 (human B-lymphocyte-restricted differentiation antigen, Bp35), which is expressed on B-cells. The Fc domain recruits immune effector functions to mediate B-cell lysis. Possible mechanisms of cell lysis include complement-dependent cytotoxicity (CDC) and antibody-dependent cell mediated cytotoxicity (ADCC).[1][2][3]
Route: IV
Extravasation: neutral
For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias such as Micromedex, Lexicomp, UpToDate (courtesy of Lexicomp), or the prescribing information.[1]
Diseases for which it is established (work in progress)
- Chronic lymphocytic leukemia
- Diffuse large B-cell lymphoma
- Follicular lymphoma
- Mantle cell lymphoma
- Marginal zone lymphoma
- Waldenström macroglobulinemia
Diseases for which it is used
- Acquired hemophilia A
- Acquired thrombotic thrombocytopenic purpura
- Immune thrombocytopenia
- B-cell acute lymphoblastic leukemia
- B-cell lymphoma of mucosa-associated lymphoid tissue
- Burkitt lymphoma
- Castleman disease
- CNS lymphoma
- Cold agglutinin disease
- Hairy cell leukemia
- High-grade B-cell lymphoma
- HIV-associated lymphoma
- Classical Hodgkin lymphoma
- Hodgkin lymphoma, nodular lymphocyte-predominant
- Inherited coagulopathy with inhibitor
- Mediastinal gray-zone lymphoma
- Non-Hodgkin lymphoma, pediatric
- Post-transplant lymphoproliferative disorder
- Primary mediastinal B-cell lymphoma
- Acquired thrombotic thrombocytopenic purpura
- Transformed lymphoma
- Warm autoimmune hemolytic anemia
Patient drug information
- Rituximab (Rituxan) package insert[1]
- Rituximab (Rituxan) patient drug information (Chemocare)[4]
- Rituximab (Rituxan) patient drug information (UpToDate)[5]
History of changes in FDA dosing recommendations
- 2012-10-19: Approved for 90-minute infusion in previously untreated diffuse large B-cell lymphoma (DLBCL) and follicular Non-Hodgkin lymphoma (NHL) starting with cycle 2:[6]
- Patients who do not experience a grade 3 or 4 infusion related adverse event during cycle 1 may undergo a 90-minute infusion when used as part of a glucocorticoid-containing chemotherapy regimen. In cycle 2, 20% of the total dose is to be given over the first 30 minutes, and the remaining 80% of the total dose is to be given over the last 60 minutes. If this 90-minute infusion is tolerated, the same rate can be used for remaining cycles of the treatment.[1][7][8][9]
History of changes in FDA indication
Note: there is a gap in FDA labels between 1997 and 2006 on the FDA website; there are likely missing indications issued during that time period.
Chronic lymphocytic leukemia
- 2010-02-18: Approved in combination with fludarabine and cyclophosphamide (FC), for the treatment of previously untreated and previously treated patients with chronic lymphocytic leukemia (CLL). (New disease entity; based on GCLLSG CLL8 & REACH)
Diffuse large B-cell lymphoma
- 2006-02-10: Approved for use in the first-line treatment of patients with diffuse large B-cell, CD20-positive, non-Hodgkin's lymphoma in combination with CHOP or other anthracycline-based chemotherapy regimens. (new disease entity added; scope expanded to first-line treatment; combination therapy required; based on ECOG E4494, LNH 98-5, NCIC-CTG LY.9)
Follicular lymphoma
- 1997-11-26: Initial FDA approval for the treatment of patients with relapsed or refractory follicular, CD20 positive, B-cell non-Hodgkin’s lymphoma. (Based on Maloney et al. 1997a & McLaughlin et al. 1998)
- 2006-09-29: Approved for the first-line treatment of patients with follicular, CD20-positive B-cell non-Hodgkin’s lymphoma. (scope expanded to first-line treatment; based on M39021)
- 2011-01-28: Approved for maintenance therapy for patients with previously untreated follicular, CD-20 positive, B-cell non-Hodgkin lymphoma who achieve a response to rituximab in combination with chemotherapy. (Approval extended to maintenance setting; based on ECOG E1496 & PRIMAFL)
Indolent (Low grade) lymphoma
- 1997-11-26: Initial FDA approval for the treatment of patients with relapsed or refractory low-grade, CD20 positive, B-cell non-Hodgkin’s lymphoma. (Based on Maloney et al. 1997a & McLaughlin et al. 1998)
- 2006-09-29: Approved for the first-line treatment of patients with low grade, CD20-positive B-cell non-Hodgkin’s lymphoma. (scope expanded to first-line treatment; based on M39021)
Pediatric lymphoma/leukemia
- 2021-12-02: Approved in combination with chemotherapy for pediatric patients (at least 6 months to less than 18 years) with previously untreated, advanced stage, CD20-positive diffuse large B-cell lymphoma (DLBCL), Burkitt lymphoma (BL), Burkitt-like lymphoma (BLL), or mature B-cell acute leukemia (B-AL). (Based on Inter-B-NHL Ritux 2010)
History of changes in EMA indication
- 1998-06-02: Initial marketing authorization as MabThera.
History of changes in PMDA indication
- 2013-06-14: New additional indication and a new dosage for the treatment of CD 20-positive B-cell lymphoproliferative disorders in immunocompromised patients.
- 2017-06-26: New additional indication and a new dosage for the treatment of chronic idiopathic thrombocytopenic purpura.
- 2019-03-26: New additional indication and a new dosage for the treatment of CD20-positive chronic lymphocytic leukemia.
- 2020-02-21: New indication and a new dosage for the treatment of acquired thrombotic thrombocytopenic purpura.
Also known as
- Code names: BI-695500, IDEC-102, IDEC-C2B8, RTXM-83
- Brand names: Ikgdar, Mabtas, MabThera, Reditux, Ristova, Rituxan, Rituxim, Transera-Kit
References
- ↑ 1.0 1.1 1.2 1.3 Rituximab (Rituxan) package insert
- ↑ Rituximab (Rituxan) package insert (locally hosted backup)
- ↑ Rituxan manufacturer's site
- ↑ Rituximab (Rituxan) patient drug information (Chemocare)
- ↑ Rituximab (Rituxan) patient drug information (UpToDate)
- ↑ FDA Approves New Dosing and Administration Information for Rituximab (2012-10-19) Hematology.org, accessed 2012-10-19
- ↑ Atmar J. Review of the safety and feasibility of rapid infusion of rituximab. J Oncol Pract. 2010 Mar;6(2):91-3. link to original article contains dosing details in manuscript link to PMC article PubMed
- ↑ Sehn LH, Donaldson J, Filewich A, Fitzgerald C, Gill KK, Runzer N, Searle B, Souliere S, Spinelli JJ, Sutherland J, Connors JM. Rapid infusion rituximab in combination with corticosteroid-containing chemotherapy or as maintenance therapy is well tolerated and can safely be delivered in the community setting. Blood. 2007 May 15;109(10):4171-3. Epub 2007 Jan 23. link to original article contains dosing details in manuscript PubMed
- ↑ Dakhil S, Hermann R, Schreeder MT, Gregory SA, Monte M, Windsor KS, Hurst D, Chai A, Brewster M, Richards P. Phase III safety study of rituximab administered as a 90-minute infusion in patients with previously untreated diffuse large B-cell and follicular lymphoma. Leuk Lymphoma. 2014 Oct;55(10):2335-40. Epub 2014 Mar 7. PubMed
Categories:
- Drugs
- Intravenous medications
- Neutral
- Protein expression-specific medications
- Anti-CD20 antibodies
- Acquired hemophilia A medications
- Acquired thrombotic thrombocytopenic purpura medications
- B-cell acute lymphoblastic leukemia medications
- Burkitt lymphoma medications
- Castleman disease medications
- CNS lymphoma medications
- Chronic lymphocytic leukemia medications
- Cold agglutinin disease medications
- Diffuse large B-cell lymphoma medications
- Follicular lymphoma medications
- Hairy cell leukemia medications
- High-grade B-cell lymphoma medications
- HIV-associated lymphoma medications
- Classical Hodgkin lymphoma medications
- Hodgkin lymphoma, nodular lymphocyte-predominant medications
- Immune thrombocytopenia medications
- Inherited coagulopathy medications
- MALT lymphoma medications
- Mantle cell lymphoma medications
- Marginal zone lymphoma medications
- Mediastinal gray-zone lymphoma medications
- Post-transplant lymphoproliferative disorder medications
- Primary mediastinal B-cell lymphoma medications
- Transformed lymphoma medications
- Waldenström macroglobulinemia medications
- Warm autoimmune hemolytic anemia medications
- EMA approved in 1998
- FDA approved in 1997
- PMDA approved drugs
- WHO Essential Cancer Medicine