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