Rituxan

An autoimmune disorder where the body essentially attacks its own joints, Rheumatoid Arthritis is a painful condition afflicting more than 1.3 million Americans. And, in most cases, women are victims of this debilitating disease – over 75% of the cases of RA are found in women.

In more minor or less advanced cases of Rheumatoid Arthritis, individuals will have significant joint pain due to joint inflammation. In more moderate to severe cases of RA, individuals can experience bone erosion, joint deformity, and attack of nearby organs.

Treatment to alleviate the symptoms of Rheumatoid Arthritis include drug therapy, physical therapy, and homeopathic medicines. In more advanced stages of Rheumatoid Arthritis, a drug called Rituxan has been approved for treatment, usually in combination with a TNF (tumor necrosis factor) antagonist that did not work well enough on its own.

 

What is Rituxan?

Rituxan (Rituximab) is an antibody that works to inhibit CD20,a protein found on the surface of mature B-cells. CD20 and B-cells are responsible for promoting inflammation in our bodies in response to damage. With RA, our bodies are basically attacking themselves, creating joint inflammation when no injury is present. As such, Rituxan is prescribed to interfere with this process – so the body will not release signals to encourage joint inflammation. Thus, minimizing the occurrence of the inflammation, and the pain associated with this inflammation.

There have been a number of clinical trials conducted to study the effects of Rituxan on RA symptoms. In all controlled studies, Rituxan was found to have a beneficial effect on the treatment of RA symptoms over just methotrexalate alone, placebos, and methotrexalate + placebos. One of the most recent clinical studies of Rituxan shows that there is little to no significant difference between users who take Rituxan at high doses versus those that take it in low doses to treat RA in combination with steroids. This is good news for the Rheumatoid Arthritis community, considering there are usually many negative side effects of using steroids in treatment of RA. These results suggest that steroids are not needed in combination with RA drugs, and lower doses of Rituxan are virtually just as effective as higher doses of the drug.

 

How to Take It

Rituxan is given intravenously. As it is usually given in combination with the DMARD methotrexalate, two separate infusions are given into the vein of 1000mg at two week intervals. Beyond the initial treatment, Rituxan is given at 24 week intervals.

Rituxan infusions usually last anywhere between 4-6 hours. Courses of Rituxan should not be given at intervals less than 16 weeks.

 

Side Effects

Some side effects from taking Rituxan can be severe, even deadly. It’s important to consult with your doctor if you experience any of the following after taking Rituxan:

  • Stomach upset/problems/pain
  • Bowel upset/pain
  • Chest pain
  • Irregular heart beat
  • Kidney problems
  • Tumor Lysis Syndrome (TLS)
  • Resultant infections
  • Skin and mouth reactions
  • Hepatitis B virus reactivation
  • Progressive Multifocal Leukoencephalopathy (PML)
  • Low blood cells counts

Because some of these side effects can be life threatening, it’s important to contact your physician right away if you suspect you are experiencing any negative effects from the use of Rituxan.

Some less severe/more common side effects of Rituxan typically occur right after the infusion is complete. These more mild symptoms include:

  • Fever
  • Chills
  • Body aches
  • Infusion reactions
  • Tiredness
  • Aching joints
  • More frequent respiratory tract infections

 

Warnings and Precautions

Because Rituxan can interact with other types of medications and/or worsen symptoms of existing diseases, it’s important to let your doctor know if you experience any of the following:

  • Heart problems
  • Lung or kidney problems
  • Severe reaction to Rituxan
  • Currently have an infection or a weakened immune system
  • Have recently had or will be having a vaccine
  • Are pregnant or trying to get pregnant
  • Are breastfeeding or plan on breastfeeding
  • Are taking any medications, especially TNF inhibitor medications or DMARDs