Dosing Rituxan for GPA and MPA is based on body surface area

DOSING AND ADMINISTRATION FOR GPA & MPA INDUCTION THERAPY

Administer Rituxan for GPA and MPA 1x weekly for 4 weeks

 

Induction dosing[11]

Rituxan should only be administered by a healthcare professional with appropriate medical support to manage severe infusion-related reactions that can be fatal if they occur.[11] Premedicate with acetaminophen and an antihistamine before each infusion of Rituxan.

Glucocorticoids administered as methylprednisolone 1000 mg intravenously per day for 1 to 3 days followed by oral prednisone 1 mg/kg/day (not to exceed 80 mg/day and tapered per clinical need) are recommended to treat severe vasculitis symptoms. This regimen should begin within 14 days prior to or with the initiation of Rituxan and may continue during and after the 4-week course of Rituxan treatment.[11]

Step 1:
Calculate body surface area (BSA) of the patient using his/her height and weight
Step 2:
Using the patient's BSA, calculate the weekly Rituxan dose with the following formula[11]:Weekly dose=BSA (m2) × 375 mg
Step 3:
Rituxan should be administered once weekly for 4 weeks[11]
  • Following methylprednisolone infusions, oral prednisone 1 mg/kg/day is recommended (not to exceed 80 mg/day and tapered per clinical need)[11]

PCP prophylaxis

PCP prophylaxis is also recommended for patients with GPA or MPA during treatment and for at least 6 months following the last Rituxan infusion.[11]

GPA, granulomatosis with polyangiitis; MPA, microscopic polyangiitis; PCP=Pneumocystis jirovecii pneumonia.

DOSING AND ADMINISTRATION FOR GPA & MPA FOLLOW-UP THERAPY

If induction treatment of active disease was with Rituxan, follow-up treatment with Rituxan should be initiated within 24 weeks after the last Rituxan induction infusion or based on clinical evaluation, but no sooner than 16 weeks after the last Rituxan induction infusion.[11]

If induction treatment of active disease was with other standard of care immunosuppressants, Rituxan follow-up treatment should be initiated within the 4-week period that follows achievement of disease control.[11]

Administer Rituxan as two 500 mg intravenous infusions separated by two weeks, followed by a 500 mg intravenous infusion every 6 months thereafter based on clinical evaluation.[11]

Patients should receive 100 mg intravenous methylprednisolone to be completed 30 minutes prior to each Rituxan infusion.[11]

Follow-up dosing[11]