New Rituxan Dosing

A couple of weeks ago, ASH sent an announcement out that a new Rituxan dosing schedule had been approved by the FDA.

Patients who did not have a severe reaction during their first dose, and who do not have cardiovascular or high lymphocyte counts, may receive their second and subsequent doses in 90 minutes. The amount of Rituxan will be the same, but it will get in there a lot faster: 20% of the dose given in the firt 30 minutes, and then the rest given in 60 minutes. This change is based on a trial involving patients who took Rituxan along with CVP or CHOP.

Compare this to my own experience. My first dose of Rituxan took about 5 hours. I had to stop partway into it because I had an allergic reaction. A dose of medicine to counter that, and then a much slower drip, and I was on my way. Other doses took about 4 hours each, going fairly slowly, just in case there was an issue, though typically people only have a reaction with the first dose.

So this new protocol works things  a lot faster. If the patient sails through the first dose OK, there's really no reason to take things slower.

So who benefits by this?

Well, first, the patient. It sucks having to sit there for 4 or 5 hours. Dr. R has a nice treatment room, with comfy chairs, TV, books to read, snacks to eat. But it still sucks. Particularly for someone who is mostly asymptomatic, as I was -- someone who is living a fairly "normal" lifestyle, which is true of lots of fNHL patients. It would be nice to be able to get back to work, maybe, if that's possible.

The treatment host benefits. Open up a chair faster, if that's necessary -- get some juice into someone who needs it.

And who else benefits? Everyone. If we're trying to reduce costs for health care, which ultimately helps us all, then the faster infusions might just do that. A paper to be presented at ASH next month addresses that very issue, and concludes that reducing each Rituxan dose from 4 hours to 90 minutes saves $359. The number of doses given to a patient varies, but the paper's authors estimated that the saving would be $2,119 per course. [Thanks to Karl from Patients Against Lymphoma for pointing out that link to the support group.]

Seems small, but it adds up, given how many people get Rituxan every year. And imagine similar small savings for every cancer treatment, with no change in effectiveness. We'd really have something going there, wouldn't we?