Skip to main content
Log in

Rapid infusion with rituximab: short term safety in systemic autoimmune diseases

  • Short Communication
  • Published:
Rheumatology International Aims and scope Submit manuscript

Abstract

To describe the incidence, types and severity of adverse events, related to an accelerated regime of rituximab infusion in patients with various autoimmune diseases. Fifty-four patients with systemic autoimmune disease, to be treated with 1,000 mg of rituximab twice 2 weeks apart, participated. Pre-medication (oral prednisolone, anti-histamine and paracetamol) was administered 1–4 h before infusion start. The first infusion was administered over a period of 195 min. The second infusion over a period of 90 min. Any adverse events were classified using the Clinical Trials Classification of Adverse Events (CTCAE) v. 3.0. Ten patients (18.5%) experienced at least one infusion-related reaction (IRR) ever. The first infusion was associated with reactions in 4 CTCAE categories of which rhinitis were the most frequent. The CTCAE severity grading showed six patients (11.1%) had a grade 1 reaction. One patient (1.8%) had grade 2 events on both infusions and two patients (3.6%) had a grade 3 event on both infusions. RA patients more often had an infusion-related reaction (IRR) (9.2%) than the rest. The types of IRR were mostly of allergic or angio-oedematic nature. In practise, the rapid infusion was an easy to use regime and the second infusion is of time sparing significance to health professionals. No unexpected side effects were observed in relation to the accelerated regime.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

References

  1. Keystone E, Fleischmann R, Emery P, Furst DE, van Vollenhoven R, Bathon J, Dougados M, Baldassare A, Ferraccioli G, Chubick A, Udell J, Cravets MW, Agarwal S, Cooper S, Magrini F (2007) Safety and efficacy of additional courses of rituximab in patients with active rheumatoid arthritis: an open-label extension analysis. Arthritis Rheum 56(12):3896–3908

    Article  PubMed  CAS  Google Scholar 

  2. Cohen SB, Emery P, Greenwald MW, Dougados M, Furie RA, Genovese MC, Keystone EC, Loveless JE, Burmester GR, Cravets MW, Hessey EW, Shaw T, Totoritis MC, Reflex Trial Group (2006) Rituximab for rheumatoid arthritis refractory to anti-tumor necrosis factor therapy: results of a multicenter, randomised, double-blind, placebo-controlled, phase III trial evaluating primary efficacy and safety at 24 weeks. Arthritis Rheum 54(9):2793–2806

    Article  PubMed  CAS  Google Scholar 

  3. Gottenberg JE, Guillevin L, Lambotte O, Combe B, Allanore Y, Cantagrel A, Larroche C, Soubrier M, Bouillet L, Dougados M, Fain O, Farge D, Kyndt X, Lortholary O, Masson C, Moura B, Remy P, Thomas T, Wendling D, Anaya JM, Sibilia J, Mariette X, Club Rheumatismes et Inflamation (CRI) (2005) Tolerance and short term efficacy of rituximab in 43 patients with systemic autoimmune diseases. Ann Rheum Dis 64(6):913–920

    Article  PubMed  CAS  Google Scholar 

  4. Salar A, Casao D, Cervera M, Pedro C, Calafell M, Abella E, Alvarez-Larran A, Besses C (2006) Rapid infusion of rituximab with or without steroid-containing chemotherapy: 1-yr experience in a single institution. Eur J Haematol 77(4):338–340

    Article  PubMed  CAS  Google Scholar 

  5. Tuthill M, Crook T, Corbet T, King J, Webb A (2009) Rapid infusion of rituximab over 60 min. Eur J Haematol 82(4):322–325

    Article  PubMed  CAS  Google Scholar 

  6. Zahrani A, Ibrahim N, Al Eid A (2009) Rapid infusion rituximab changing practice for patient care. J Oncol Pharm Pract: Off Publ Int Soc Oncol Pharm Pract 15(3):183–186

    Article  Google Scholar 

  7. Provencio M, Cerdeira S, Bonilla F, Sanchez A, Espana P (2006) Rapid-infusion rituximab in lymphoma treatment. Ann Oncol: Off J Eur Soc Med Oncol/ESMO 17(6):1027–1028

    Article  CAS  Google Scholar 

  8. Sehn LH, Donaldson J, Filewich A, Fitzgerald C, Gill KK, Runzer N, Searle B, Souliere S, Spinelli JJ, Sutherland J, Connors JM (2007) 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 109(10):4171–4173

    Article  PubMed  CAS  Google Scholar 

  9. Aurran-Schleinitz T et al (2005) “One hour” rituximab infusion is safe and improves patient care and outpatient unit management. Blood 106(11). Abstract no 4759

  10. Bukh G, Larsen S, Rasmussen S, Mølgård M, Hansen M (2008) Accelerated infusion-rate of rituximab for rheumatoid arthritis is well tolerated and safe. Am Coll Rheumatol Ann Meet. San Franc. Abstract no 1885. Board no 607

  11. Gibbs s (2007). Norfolk and Norwich University Hospital, Norwich. Rapid infusion rituximab is as effective and safe as conventional infusion regimes in the treatment of diffuse large B-cell lymphoma. A 2 year prospectus study. Haematol 92(Suppl 2):264. Abstract no 0708

  12. Scoeffel DA et al (2008) Simplified treatment protocol of rituximab in rheumatoid arthritis. Ann Rheum Dis 67(Suppl II):337. Abstract (FRI0161)

    Google Scholar 

  13. Bukh G, Larsen S, Rasmussen S, Mølgård M, Hansen M (2011) Very fast infusion-rate of rituximab for rheumatoid arthritis is well tolerated and safe. Ann Rheum Dis 70(Suppl 3):754. Abstract

    Google Scholar 

  14. Siano M, Lerch E, Negretti L, Zucca E, Rodriguez-Abreu D, Oberson M, Leoncini L, Mora O, Sessa C, Gallino A, Ghielmini M (2008) A phase I-II study to determine the maximum tolerated infusion rate of rituximab with special emphasis on monitoring the effect of rituximab on cardiac function. Clin Cancer Res: Off J Am Assoc Cancer Res 14(23):7935–7939

    Article  CAS  Google Scholar 

  15. Taylor SR, Salama AD, Joshi L, Pusey CD, Lightman SL (2009) Rituximab is effective in the treatment of refractory ophthalmic Wegener’s granulomatosis. Arthritis Rheum 60(5):1540–1547

    Article  PubMed  Google Scholar 

  16. Trotti A, Colevas AD, Setser A, Rusch V, Jaques D, Budach V, Langer C, Murphy B, Cumberlin R, Coleman CN, Rubin P (2003) CTCAE v3.0: development of a comprehensive grading system for the adverse effects of cancer treatment. Semin Radiat Oncol 13(3):176–181

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

This study had no financial support from any pharmaceutical company or benefits from commercial sources.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Janni Lisander Larsen.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Larsen, J.L., Jacobsen, S. Rapid infusion with rituximab: short term safety in systemic autoimmune diseases. Rheumatol Int 33, 529–533 (2013). https://doi.org/10.1007/s00296-011-2208-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00296-011-2208-0

Keywords

Navigation