Rituxan is seeing a lot of use these days. Although technically only having formal indications for rheumatoid arthritis and non-Hodgkin’s lymphoma, it is being used for a number of off-label indications, and in general the results seem to be overall encouraging. In terms of renal disease, Rituxan is being used for the treatment of membranous nephropathy, lupus nephritis, ANCA-associated vasculitis, and antibody-mediated rejection of kidney transplants, among other things.
There are two major Rituxan dosing regimens in use. One common regimen is to give 375mg/m2 iv every week for 4 weeks.
It’s often more convenient to give another regimen, which is 1000mg iv x 1 then another 1000mg 2 weeks later.
The duration of giving further “maintenance” Rituxan is not well worked out–overall the medication is still relatively new–but one common way to do it is to give 1000mg iv every 4 months.
Since the antibody is against the CD20 molecule on B-cells, you can perform a CD20 blood count to see whether the drug is having an effect–in general it is quite efficacious.