Rituximab is a targeted DMARD (Disease modifying anti-rheumatic drug), which works to dampen down the body’s inflammatory response. In certain diseases the immune system is over active, this can target healthy tissues such as joints and blood vessels. Rituximab works to reduce the inflammatory response by blocking the immune cells called B cells. B cells make proteins that attack the normal body by mistake. Blocking these cells reduces inflammation; thereby reducing symptoms such as pain, joint swelling and tissue damage.
Rituximab is used for a few different types of conditions in rheumatology. These include:
It can take up to 4 months to have an effect in arthritis and longer in other inflammatory diseases.
Rituximab is given as a drip directly into a vein, this is also known as an infusion. It is usually given in addition to the other medications you are taking such as methotrexate.
The infusion is given slowly and the dose increased in steps to ensure that you don’t develop side effects. Your blood pressure and observations are monitored throughout. The drip takes around 6 hours to give the total dose of 1000mg. It is then repeated for a second infusion of 1000mg, 2 weeks later on day 15.
The infusion is usually given in the Rheumatology day unit.
Medications to help prevent side effects are given at the same time; these include steroids, paracetamol and antihistamines.
If you tolerate the infusion well, it can be given quicker in subsequent doses. The doses are usually given when you begin to flare, this is at least 6 months after the 1stcourse. Some patients manage well and do not need another course for up to 1 year.
Before each dose of rituximab, you will need to have your bloods checked to ensure that your blood counts, liver and kidney function are stable.
Before your first infusion, your bloods will also be checked for immunoglobulin’s to ensure that we do not cause your immune system to be reduced too much.
Sometimes rituximab can cause a reaction during the infusion. The chance is reduced as medications are given alongside it to prevent this from happening.
Other possible side effects include:
Interactions with other medications
Contraindications of other conditions
During pregnancy and breastfeeding
Versus Arthritis: http://www.versusarthritis.org