Title:The Influence of Different Disease States on Rituximab Pharmacokinetics
Volume: 21
Issue: 12
Author(s): Xiaoxing Wang, Wenwen Du, Xianglin Zhang* Pengmei Li*
Affiliation:
- Department of Pharmacy, China-Japan Friendship Hospital, Beijing 100029,China
- Department of Pharmacy, China-Japan Friendship Hospital, Beijing 100029,China
Keywords:
Rituximab, pharmacokinetics, pharmacodynamics, B-cell malignancies, autoimmune diseases, monoclonal antibody.
Abstract: Background: The anti-CD20 antibody rituximab, which promotes the selective depletion of CD20 positive
B cells, was the first targeted therapy that was approved for the treatment of B-cell malignancies, and it is now
widely prescribed in both malignant and non-malignant, immune-related diseases. However, the cause of its various
clinical responses in certain diseases, have not been clearly elucidated. The variabilities in inter-individual pharmacokinetic
and the emerging evidence of the relationships between pharmacokinetic and pharmacodynamic may provide a
better understanding of this drug.
Methods: We searched and summarized the latest published articles on rituximab pharmacokinetic profiles and the
pharmacokinetic/pharmacodynamic models in different patient populations, including B-cell malignancies, rheumatoid
arthritis, ANCA-associated vasculitis, and glomerular kidney diseases.
Results: Most pharmacokinetic data are drawn from clinical studies in oncology clinical practice. Body weight, gender,
and antigen-related factors are proven to be the key factors affecting rituximab pharmacokinetics. In addition,
the positive exposure-response relations were reported, which provide encouraging evidence for individualized
therapies. While in immune disorders, especially in the off-labeled indications, pharmacokinetic studies are quite
limited. Compared with that in B-cell malignancies, the differences in the pharmacokinetic parameters may be attributed
to the different pathogeneses of diseases, mechanisms of action and dosing strategies. However, the correlation
between drug exposure and clinical outcomes remains unclear.
Conclusion: Here, we provide an overview of the complexities associated with rituximab pharmacokinetics and
pharmacodynamics in different diseases. Although many influencing factors need to be verified in future studies, a
better understanding of the relationships between pharmacokinetic and pharmacodynamic may assist in optimizing
rituximab clinical practice.