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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


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

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

COVID-19 vaccination in patients with rheumatic diseases

Get answers to key questions with recommendations from professional organizations