NICE guidance - rituximab in combination with glucocorticoids for treating anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis

Last reviewed 10/2020

NICE have suggested that (1):

• rituximab, in combination with glucocorticoids, is recommended as an option for inducing remission in adults with anti-neutrophil cytoplasmic antibody [ANCA]-associated vasculitis (severely active granulomatosis with polyangiitis [Wegener's] and microscopic polyangiitis), only if:
  • further cyclophosphamide treatment would exceed the maximum cumulative cyclophosphamide dose or
    
    
  • cyclophosphamide is contraindicated or not tolerated or
    
    
  • the person has not completed their family and treatment with cyclophosphamide may materially affect their fertility or
    
    
  • the disease has remained active or progressed despite a course of cyclophosphamide lasting 3-6 months or
    
    
  • the person has had uroepithelial malignancy.

Notes (1):

• rituximab is a genetically engineered chimeric (mouse/human) monoclonal antibody that depletes B cells by targeting cells bearing the CD20 surface marker

Reference:

• NICE (March 2014). Rituximab in combination with glucocorticoids for treating anti-neutrophil cytoplasmic antibody-associated vasculitis