to B or not to B: Rituxan

Rituxan has been around for a while. It can be called Rituxan (brand name) or rituximab (generic name).

Rituxan’s main indication is for Non-Hodgkin’s Lymphoma. You can find out more about the drug, including side-effects, by clicking here, although there is no information on its use for myositis on this website.

Rituximab targets a protein on B cells.

B cells are key components of the adaptive immune response. They produce antibodies, proteins that allow the body to remove infectious or other dangerous particles. B cells also produce chemicals that help other parts of the immune system do their jobs. However, people with certain auto-immune disorders make B cells that do not work the way they should. These abnormal B cells do not interact properly with other parts of the immune system and can attack a person’s own body even if there is no infection (which is called an autoimmune response).

Rituximab is a type of immunotherapy known as a monoclonal antibody.

A monoclonal antibody is a man-made version of an immune system protein that fits like a lock and key with one certain protein. Rituximab is designed to seek out and lock onto the protein receptor (CD20) found on B lymphocytes (B cells) in the body. Once the antibody attaches to the cells, it brings in other immune cells to help kill them. Although this B cell suppression may make it slightly harder for you to fight off infections, it also helps to stabilize an overactive immune system. After the last infusion it can take months, perhaps a year for the B cells to fully replenish.

Most common side effects of Rituxan include:

  • Infusion reactions
  • Chills
  • Infections
  • Body aches
  • Tiredness
  • Low white blood cell count

Less common and more serious side effects include:

  • Severe skin and mouth reactions
  • Infection problems
  • Hepatitis B virus (HBV) reactivation
  • Progressive Multifocal Leukoencephalopathy (PML)
  • Tumor Lysis Syndrome (TLS)
  • Heart problems
  • Kidney problems
  • Stomach and bowel problem

 

There has been a study funded by TMA and led my Dr. Chester V. Oddis into Rituxan in treatment of Myositis (RIM). The trial, which was very positive, can be viewed by clicking here. For dermatomyositis and polymyositis patients it is usually used in conjunction with methotrexate (I have never been on methotrexate – Nicole & I were adamant about not using methotrexate in 2007 because we knew we wanted to start a family and methotrexate causes horrible birth defects and takes a long time to clear your system once/if you get off of it.)

If you have any questions on Rituxan, TMA is conducting a live discussion on this very subject on June 20th. Click here for details. They have also conducted a past Live Discussion on the drug. Click here to read that.

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