Could someone please explain to me why is Rituxamab is:
a.) Given only to certain patients?
b.) WHY is it given (i.e. what benefit do patients get from it?)
c.) Is it likely to be given to ALL Vasculitis patients in the future?
If someone could enlighten me I would be grateful!
Thanks.
Couple of articles you might like to look at on the Trust's website - vasculitis.org.uk. Under "About Vasculitis" look at the Glossary of Drugs and then for Rituximab, and under "About us" look at the Newsletters - Autumn 2010 page 10 and Spring 2011 page 10. That should give you a little info.
PatriciaAnn
Just a minor edit to the above address (as it doesn't work due to the full stop at the end) Go to vasculitis.org.uk/about-vas... and vasculitis.org.uk/about/new...
a) Conventional immunosuppressant treatment (e.g. cyclophosphamide) is the normal route using drugs licensed to treat the disease. If and when they fail non-licenced drugs such as Rituximab and Alemtuzumab (aka Campath-1H) may be used at the clinician's discretion (subject to PCT funding policies).
b) It usually works where other drugs have failed (e.g. as in my own case of WG/GWP). It rarely produces side effects (although some do have adverse reaction to it) and is regarded as non-toxic, although studies have yet to establish if there are any long term side effects. When the current Adenbrookes protocol is used (2 doses a fortnight apart then a dose every 6 months for 2 years) the flare rate appears to be dramatically reduced (compared to the old 'dose and wait and see' protocol).
c) V-UK have already been part of the consultation process with NICE in an attempt to get the drug licensed for adults with WG/GWP, MPA and CSS. A decision is likely in 2013. Once licensed it will still be at the clinician's discretion as to what treatment is used. As things stand Rituximab is no more efficient at inducing remission than cyclophosamide but has the obvious non-toxicity and additional benefit as described in (b). I personally will continue to campaign for this drug to be the front-line, gold-standard, first-choice for appropriate vasculitis conditions/cases.
Hope this answers your questions.
Healthy wishes.
The only thing I'd clarify, which has been touched on by other people replying, is that Rituximab has been found to be sometimes effective in some specific forms of vasculitis, but not all. So for example it isn't being considered as a viable treatment for my aggressive cerebral vasculitis (small vessel, not ANCA positive), for which we have tried many other treatments since 1998, including Cyclophosphamide, without adequate success. Instead we are now looking at different biologics which may be more appropriate to my case.
Thanks for the explanation guys. Much appreciated.
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