Approved nephrologic indication:

• Granulomatosis with Polyangiitis (GPA) (Wegener’s Granulomatosis)
• Microscopic Polyangiitis (MPA) in adult patients in combination with glucocorticoids

MOA:

• Monoclonal antibody that binds to CD20 on pre-B and mature-B lymphocytes leading to B-cell death

Dosing:

• 375 mg/m2 weekly for 4 weeks
• Glucocorticoids administered prior to or with initation: 1000 mg IV methylprednisolone for 1-3 days, followed by oral prednisone 1 mg/kg/day are recommended to treat severe vasculitis symptoms
• Safety and efficacy of treatment with subsequent courses of Rituxan have not been established

Adverse effects:

• Renal toxicity, progressive multifocal leukoencephalopathy (PML) mucocutaneous reactions, hepatitis B reactivation, infections²³

Treatment for:

Approved indication:

• No FDA-approved post-transplant nephrology indication – recommended as a potential treatment option during post-transplant membranoproliferative glomerulonephritis (MPGN) recurrence

MOA:

• Monoclonal antibody that binds to complement protein C5, inhibiting its cleavage to C5a and C5b and preventing the generation of the terminal complement complex C5b-9

Dosing:

• 900 mg intravenously once weekly for 4 weeks, followed by 1200 mg intravenously in week 5

Adverse effects:

• No adverse events reported for MPGN recurrence treatment^30,31