Low dose Rituxan

Introduction: Rituximab (RTX) is used off label to treat immune thrombocytopenia (ITP) but the regimen now commonly used in rheumatoid arthritis has not been evaluated in ITP. The aim of this large French multicenter retrospective study was to compare the efficacy and safety of two RTX regimens in adult's ITP. Patients and methods: In this multicenter retrospective study, the efficacy of two (RTX) regimens: standard therapy of 375 mg/m2 weekly for 4 weeks vs. a rheumatoid arthritis (RA) regimen of 1000 mg on days 1 and 15, to treat ITP was compared. We included adults patients with previously treated primary ITP with RTX. (CR) was defined as a platelet count >100 x 109 /L, and a response (R) by a platelet count of >30 x 109 /L with a least a doubling of the baseline value. Results: Of the 107 patients included, 61 (57%) received the standard regimen and 46 (43%) the RA regimen. Baseline characteristics and overall response rates at the end of 3 month (M3) and 12 months (M12) were not significantly different between the groups. At M12, 22/61 patients (36%) treated with the standard regimen and 23/46 (50%) with the RA regimen achieved an overall response (R + CR). The initial pattern of response at M3 was associated with a later pattern of response by M12 in both groups. In multivariate analysis, both having a younger age and a low number of previous therapies were associated with a higher likelihood of overall response at M12. Tolerance was good and comparable between the two groups. Conclusion: The RA regimen is an effective and safe alternative to the standard regimen to treat adults with ITP.



www.ncbi.nlm.nih.gov/pubmed/23798363

I have seen this a few times, but I am confused...4x375 is only 1500...2@1000 wouldn't that end up being more?? Maybe it is different with medicine, I am just confused

What does this mean: 375 mg/m² ?
Are patients now being measured in square meters>
Was this study done in flatland?

Rob16 wrote: What does this mean: 375 mg/m² ?
Are patients now being measured in square meters

Exactly so.

Here's a calculator to work it out www.patient.co.uk/doctor/body-surface-area-calculator-mosteller

But the option outlined here for RA isn't low dose. Low dose for ITP means 100 mg a week which is far, far less.

I am so glad that they are reporting this. If patients don't really need the old high dose, it's better not to have it. Now I just hope that doctors begin to follow it.

Hey I wonder if they brought out a new protocol for Rituxan. If it is a lower dose does that mean it would be cheaper. Because if it was than I'd be willing to buy the treatment. I got over 6 years on the last treatment i'd be willing to pay for another 6 years. Oh heck even it if only lasted 4 long enough for me to pay off some of my school debt.

I'm exhausted working full time I want to cut back hours!!!

The real low dose rituximab of 100mg x 4 weeks will be much cheaper although you've still got the administration charges for it but then it's quicker to administer, and also safer.

It's not new, I was offered it 7 years ago. I didn't do rituximab at all in the end for reasons but still.

Articles here..
www.haematologica.org/content/93/6/930.full
www.haematologica.org/content/92/12/1695.full

I've been offered the RA rituxan dose too. In fact I was told it was the only option - not that I'd be asking for a higher dose if there was one! Like Ann I refused it for other reasons.

I am in Ontario Canada Rituxan/ Rituximab is not yet declared usable for ITP. So I would have to pay for the drug. I was in a drug study for Rituxan years ago and that is how I got it free.

That reminds me I must contact the doctors office to see if the doctor had any luck in contacting the people who did the drug study to see if I could get the drug again!

Gee, Julia, sorry you have to pay for it. I got mine free. That was 4 years ago, so don't know if it would be free again. I certainly wouldn't be able to afford it if I had to pay the next time, if there is one.

Cindy When I meet my new hematologist in October I can discuss it with him then to see if there is a way for me to get it!

Good luck! I hope you can get it at no cost to you!

When I got the "low dose" in 2008 I asked my doc if I could get 2 x 200mg instead of 4 x 100 mg. She didn't see why not. If I opted to do it again I'd go for 1 x 400 mg and just get it over with.

I got a partial response from my one and only rituxan treatment.