Rituximab and rheumatology practice in the COVID-19 era

Balancing disease control and infection risk

What you need to know

Rituximab, a monoclonal antibody targeting CD20 that depletes B cells, is used in the treatment of a number of rheumatic diseases, but recent data point to an increased risk for SARS-CoV-2 infection and an impaired response to COVID-19 vaccines among rituximab-treated patients.

Browse below for in-depth discussion about how rheumatologists can respond to the challenges associated with rituximab in the COVID-19 era, news on the latest research, and a summary of rituximab’s approved indications within rheumatic and other autoinflammatory diseases.

Rituximab use in the COVID-19 era: striking the right balance

With rituximab-treated patients having an elevated risk for severe COVID-19 and a reduced likelihood of responding to vaccines, Sebastian Sattui and David Jayne discuss how these challenges can be addressed and explore the future role of the drug for the treatment of rheumatic diseases (13:17).

The latest research on rituximab and COVID-19

26-04-2022 | BSR 2022 | Conference coverage | News

COVID-19: Support for pausing rituximab, considering other treatments in people with RA

14-02-2022 | COVID-19 | News

Meta-analysis confirms negative impact of rituximab on COVID-19 vaccine response

20-01-2022 | COVID-19 | News

Rituximab-treated patients with ANCA-associated vasculitis may not respond to third COVID-19 vaccine dose

20-01-2022 | COVID-19 | News

Similar response to heterologous vs homologous COVID-19 booster jab in rituximab-treated patients

10-01-2022 | COVID-19 | News

B-cell threshold for COVID-19 vaccine response defined in rituximab-treated patients

07-01-2022 | COVID-19 | News

Rituximab and COVID-19 vaccination: Timing may be key for antibody response

More news on rituximab and COVID-19

Summary of rituximab approvals in the USA and Europe for autoinflammatory disease

FDA approvals	EMA approvals
Rheumatoid arthritis: in combination with methotrexate for the treatment of adult patients with moderate-to-severe disease and an inadequate response or intolerance to one or more TNF inhibitors	Rheumatoid arthritis: in combination with methotrexate for severe active disease in adult patients with an inadequate response to other DMARDs including at least one TNF inhibitor
Granulomatosis with polyangiitis and microscopic polyangiitis: in combination with glucocorticoids for patients aged 2 years and older	Granulomatosis with polyangiitis and microscopic polyangiitis: in combination with glucocorticoids for treating adult patients with severe active disease and inducing remission in pediatric patients aged 2 years and older with severe active disease
Pemphigus vulgaris: adult patients with moderate-to-severe disease	Pemphigus vulgaris: patients with moderate-to-severe disease

Research on rituximab as a treatment option for other rheumatic diseases

09-11-2021 | ACR 2021 | Conference coverage | News

BLISS-BELIEVE: Adding rituximab to belimumab does not improve SLE disease control

26-10-2021 | Systemic lupus erythematosus | News

Rituximab then belimumab may warrant further investigation for refractory SLE

30-09-2021 | Polymyalgia rheumatica | News

‘Encouraging’ results for rituximab in patients with polymyalgia rheumatica

24-06-2021 | Systemic sclerosis | News

DESIRES trial demonstrates promise for rituximab in systemic sclerosis

04-06-2021 | EULAR 2021 | Conference coverage | News

Promise for belimumab, rituximab combination in patients with primary Sjögren's syndrome

01-06-2020 | ANCA-associated vasculitis | Highlight | News

MAINRITSAN3: Prolonged rituximab recommended for maintenance of remission in AAV

10-11-2019 | ANCA-associated vasculitis | ACR/ARP 2019 | News

Support for rituximab maintenance therapy in ANCA-associated vasculitis

28-05-2019 | Systemic lupus erythematosus | News

Predictors of rituximab response identified in patients with SLE

Featured articles

Dr Zachary Wallace is a rheumatologist and clinical epidemiology researcher at Massachusetts General Hospital (MGH) and an Assistant Professor of Medicine at Harvard Medical School in Boston, Massachusetts, USA.

In this feature article, Zachary Wallace discusses the changes that have occurred in rheumatology practice as a result of the COVID-19 pandemic, and explores what lessons can be taken forward to improve patient care.

Read the article

Medicine Matters Rheumatology