JointHealth™ express   September 27, 2012

Common Drug Review recommends rituximab for vasculitis

On August 16, 2012, the Common Drug Review (CDR) recommended that when people do not have private insurance, provincial drug plans cover the cost of rituximab (Rituxan®) to induce remission in those with severely active granulomatosis with polyangiitis (GPA, also known as Wegener’s granulomatosis) or microscopic polyangiitis (MPA), which are forms of vasculitis. Click here to read the complete Common Drug Review recommendations and reasons.

This medication received its Notice of Compliance (license to sell) for the treatment of vasculitis from Health Canada on December 12, 2011.

Wegener’s granulomatosis and MPA are disorders that cause blood vessel inflammation, or vasculitis. The signs and symptoms of vasculitis vary depending on which blood vessels and organ systems are affected. In GPA and MPA, the immune system can attack the respiratory tract (sinuses, nose, trachea, and lungs), kidneys, eyes, nerves and skin.

Rituximab belongs to the class of medications called “biologics” (short for biologic response modifiers), which target the specific pathways responsible for causing inflammation. It is a kind of monoclonal antibody. Antibodies are proteins produced by the body that bind to another protein called an antigen. Rituximab binds to an antigen on the surface of a particular white blood cell, called B lymphocyte, causing it to die and preventing it from attacking the body’s self. The medication is used in combination with glucocorticoids.

This recommendation is good news for adults who live with severely active GPA or MPA, who have a severe intolerance or other contraindication to cyclophosphamide, or who have failed an adequate trial of cyclophosphamide. This medication offers an important option for those with these two types of vasculitis who do not respond well to other treatment options.

The reasons for recommending rituximab were in part based on patient input information, such as patients’ concerns regarding the symptoms of pain, fatigue, difficulty breathing, and depression as well as the unpredictable nature of disease flare, which negatively impact quality of life. Patients also expressed a desire for a treatment that would reduce the need for current therapies, including corticosteroids. This highlights the importance of patients, caregivers, and patient groups participating in the input process.