Treating Cancer And Rheumatoid Arthritis Patients With Rituxan Case Study

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Pharmacology The drug that is chosen for this paper is Rituxan (Rituximab), which is prescribed for the treatment of non-Hodgkin's lymphoma; Rheumatoid arthritis; and chronic lymphocytic leukemia (Rituxan.com). This is a drug that comes with stern warnings of dangerous reactions, including serious infections, heart problems, kidney problems, stomach and serious bowel problems, and some side effects "can lead to death" (Rituxan.com).

Clinical Pharmacology

Under the heading "prescribing directions," the drug company offers "Clinical Pharmacology" -- "Mechanism of Action," "Pharmacodyamics," and Pharmacokinetics"

Pharmacodyamics

In patients suffering with Non-Hodgkin's Lymphoma (NHL), tests revealed that when NHL patients were administered Rituxan there was a depletion of "tissue-based B cells." The first study (using 166 patients) showed that "circulating CD 19-positive B cells were depleted" in the first three weeks of the test. And the depletion of B cells continued for 6 to 9 months after the treatment. As to B-cell recovery, 83% of the 166 patients began to experience recovery of B-cells at about 6 months after treatment, and "median B-cell levels" were normal a year after treatment with Rituxan.

Fourteen percent of patients treated with Rituxan had IgM and/or IgG serum levels "below the normal range" from 5 to 11 months after...

...

lymphocytes"; in fact the majority of patients experienced "near complete depletion (CD 19 counts below the lower limit of quantification, 20 cells/ul") within two weeks following their first dose of Rituxan. For at least six months after receiving the first dose of Rituxan the majority of patients had peripheral B-cell depletions, but about 4% had depletion that lasted more than 3 years. Also, for RA patients they experienced of inflammation markers such as interleukin-6 (IL-6) and C-reactive protein (CRP), among others.
Pharmacokinetics

Two hundred and three Non-Hodgkin's Lymphoma patients received 375 mg/m2 Rituxan each week for four weeks intravenously -- and Rituxan could be detected in patients' serum up to six months following those intravenous applications. The pharmacokinetic profile of Rituximab when given as 6 infusions (of 375 mg/m2) when combined with 6 cycles of CHOP chemotherapy came out the same as using Rituximab alone.

When 298 NHL patients received 6 infusions of Rituxan (once weekly or once every three weeks) the estimated median terminal elimination half-life was 22 days (the range was from 6.1 days to 52 days). A higher clearance was experienced by patients with higher CD 19-positive cell…

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