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

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

  • 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

Black box warning (summary):
  • Fatal infusion reactions
  • Severe mucocutaneous reactions
  • Hepatitis B reactivation
  • Progressive multifocal leukoencephalopathy (PML) 23
Treatment for:

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

  • 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

  • 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 treatment30,31
Black box warning (summary):
  • Serious meningococcal infections