You are here:

Briefing note: rituximab (Mabthera)

What is rituximab used for?

Rituximab can be used to treat granulomatosis with polyangiitis (GPA) and microscopic polyangiitis(MPA). These are severe forms of an inflammatory condition affecting blood vessels, known as vasculitis.

How does it work?

Rituximab is a type of medicine called a monoclonal antibody. It works by targeting and removing cells of the immune system that do not work properly in people with GPA and MPA. It is given as a drip once weekly for 4 weeks.

What does SMC advise?

SMC accepted rituximab for restricted use in combination with glucocorticoids for the induction of remission in patients with severe, active Wegener’s GPA and MPA who have relapsed following treatment with cyclophosphamide or who are intolerant to or unable to receive cyclophosphamide.

What is the evidence to support this advice?

  • A study has shown that the proportion of patients achieving remission at 6 months following one course of rituximab (an intravenous infusion weekly for 4 weeks) was similar to that following 3-6 months of oral cyclophosphamide.
  • An economic analysis compared rituximab with cyclophosphamide. There were weaknesses in the analysis presented by the submitting company and some of the assumptions made did not reflect clinical practice in Scotland. However, experts believed that rituximab would be a useful treatment option in relapsed patients and in patients who are intolerant to or unable to receive cyclophosphamide.

SMC accepted rituximab for restricted use because it fulfils an unmet need for some patients with this serious disease where there is no licensed alternative.