Prescreening to rituximab treatment: contraindications?

[Freddy]

Hello,

I have read that prior to a rtx treatment some screenings are required, e.g. HIV, HVC, HVB, ...

I wonder if any of these are contra indicative for a rituximab treatment?
Or do they need managment, e.g. co-medication like antivrial treatment?
What about other infections?

Maybe someone knows this, esp. @Jonathan Edwards ?

 

[Jonathan Edwards]

Hello,

I have read that prior to a rtx treatment some screenings are required, e.g. HIV, HVC, HVB, ...

I wonder if any of these are contra indicative for a rituximab treatment?
Or do they need managment, e.g. co-medication like antivrial treatment?
What about other infections?

Maybe some knows this, esp. @Jonathan Edwards ?

IN using rituximab in rheumatoid arthritis we did not require any screening but expected patients to have been fully medically assessed in such a way that clinical viral disease would have been picked up. There is evidence for rituximab being a problem in HVB - with risk of activation. I don't think there is evidence for a problem in other viral conditions although I may be out of date on that. If there is any reason to think there might be a problem - with past history of contacts or intravenous drug usage then it would be wise to test for such things. So far we do not have clear evidence for rituximab being useful in ME/CFS so the problem is a way off I think.

 

[Freddy]

Thank you @Jonathan Edwards !

If you are HVB positive, does this exclude you form rtx? Or is just antiviral therapy in parallel required?
I've read that 6% of the population are positive...

I know this all is future II...

 

[Jonathan Edwards]

Thank you @Jonathan Edwards !

If you are HVB positive, does this exclude you form rtx? Or is just antiviral therapy in parallel required?
I've read that 6% of the population are positive...

I know this all is future II...

HBV probably is a contraindication but I do not know the most up to date literature.

 

[minkeygirl]

I don't think there is evidence for a problem in other viral conditions although I may be out of date on that.

Next quote:

So far we do not have clear evidence for rituximab being useful in ME/CFS so the problem is a way off I think.

So then why is everyone sitting around waiting for the Mella and Fluge clinical trials to be done so they can start treating their ME?

 

[Jonathan Edwards]

So then why is everyone sitting around waiting for the Mella and Fluge clinical trials to be done so they can start treating their ME?

Because the trial may provide clear evidence. That seems a bit of a no-brainer, to be frank. We have a suggestion that there may be efficacy just as a single swallow may suggest that summer is coming. But it is wise to wait a bit longer to see if it has really arrived.