Wednesday, July 5, 2017

Rituxan Injections for Follicular Lymphoma

This news is a few weeks old now, but it's worth mentioning in case anyone missed it: The FDA has approved subcutaneous injections for Rituxan.

That means you may not need an IV infusion to get Rituxan anymore. You can get a shot under the skin instead.

(Barbara mentioned this in a comment a couple of weeks ago, and when I first wrote about this possible approval a couple of weeks ago, Popplepot commented about his experience with it. More on that below.)

The new treatment has a slightly different formula, so it's going by a different name -- Rituxan Hycela. It will include the same stuff that is in the IV version of Rituxan, plus Hyaluronidase, an enzyme that helps thin out something called Hyaluronan, a substance that surrounds the cells. The Hyaluronidase will make it easier for the Rituxan to get where it needs to go.

The biggest advantage of Rituxan Hycela will be the time it take to administer. A shot under the skin will take minutes, while the IV (as many of us know) can take hours. This is an excellent Quality of Life improvement -- we can get out of the doctor's office that much quicker.

When I wrote about this a few months ago, I called it "a shot in the arm" for Rituxan. (For those of you unfamiliar with the expression, it means a boost or an encouragement.) But I got that wrong -- Rituxan Hycela won't be given in the arm.

I'll let Popplepot describe how he received it, in a comment he left on that post that I linked above (it's been approved in the EU since 2014):

Hi Bob, I had sub cut half way through my ritux only treatment, it is administered by a tummy injection, I often joked with the nurses that I removed my six pack for a 24 pack so they had a fatter tummy to inject. It is a fantastic advance in and out in 15 minutes pretty painless sits under the skin like a gel for a day or so, I could make a smiley face by drawing with my finger on the injection site that would last for 15 mins or so lol, a bit strange you may think but I always try to bring humour to my diagnosis, especially in front of my very much loved family, i think when I smile and laugh they smile and laugh inside that Dad/ Husband/son is coping, privately it's hard but I won't let it be hard on them through me. Hope this makes sense 😉 

I replied that I thought his smiley face was disgusting and hilarious, and I wished I had this when my kids were small.

(Thank you again, Popplepot, for the information, and for having a great sense of humor about all of this. It's a way of looking at things that I absolutely agree with.)

(And thanks again, Barbara, for alerting me about the news a couple of weeks ago.)

The Rituxan Hycela shot can only be given to patients who have had one full dose of IV Rituxan. This makes sense -- the slower infusion will allow doctors and nurses to see if the patient had an allergic reaction. This will give them more time to deal with it. Once they know how to deal with it, the faster injection can be used.

So it won't be a complete replacement for IV Rituxan, but it could replace most of the time-consuming IVs that a patient gets. I have also see the injection as saving money, since the patient will spend less time being observed by a health professional. However, I haven't seen any breakdown of lower costs.



Popplepot said...

Hi Bob this made me smile all over again, thanks to rituxan I am 3 years 2 months in remission. I get days now when I forget for a few hours what I have and that's good when I do remember it passes pretty quick. I just want to say treatment or watch and wait to all in this club, time and family will prevail things do get much better. And a big thanks to you Bob you have know idea how encouraging your posts make me feel.
Wishing everyone health from sunny summer Belfast Northern Ireland.

Lymphomaniac said...

Thanks, Popplepot. Glad I could make you smile.

Unknown said...

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I really like to reading your blog !


Gail Oesterle said...

Hi, Popplepot.

Hope it's OK to reach out like this. Since you were one of the first people to try out this new method, I was wondering if you'd be willing to speak to your experiences. It's a short interview to get an understanding of the patient's view (as well as what did or did not work). I think the moderator would get a kick out of the smiley face.

Obviously, your time is valuable, and there is a $175 honorarium. You can reach me at