Rapid infusion rituximab is well tolerated in patients with primary CNS lymphoma

Modelevsky, Lisa; Tizon, Richard; Reiss, Samantha; Smith, M.; Garonce, Rachel; Kaley, Thomas

doi:10.2217/cns-2018-0001

Cited by 4 publications

(6 citation statements)

References 31 publications

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“…Utilizing chart review to analyze infusion reactions with the rapid protocol, none of the studies found a statistically significant increase in reaction rates when compared to patients receiving the standard protocol 17,20–21. Interestingly, many of the studies within this review found reaction rates to be lower with the rapid protocol than with the standard protocol,17,19,21 with 2 of the studies showing zero infusion reactions with the rapid protocol 18,20. This evidence overwhelmingly supports the idea that rapid rituximab infusion is safe.…”

Section: Results Of the Reviewmentioning

confidence: 88%

Effects of an Ocrevus Rapid Infusion Protocol: A Literature Review and Quality Improvement Project

Brandt

2023

Journal of Infusion Nursing

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The Art and Science of Infusion Nursing O crevus is an intravenous infusion therapy used for the treatment of multiple sclerosis (MS). The administration of this medication is time and labor intensive, requiring frequent monitoring and titration. 1 The entire therapy currently requires around 6 hours (3.5 hours for the Ocrevus infusion and 2.5 for premedications and observation time), which can create a significant burden on staff and patients. 2 Long infusion times can lead to poor patient adherence, 3 treatment delays due to scheduling issues, 4-5 and significant staff workload. [6][7] As many infusion centers face rising patient volume, staffing shortages, and increased orders for high-acuity medications, the impact of this problem grows. Further, the COVID-19 pandemic has made patient scheduling more difficult and increased viral exposure time dangerous, heightening the importance of reducing infusion times. LITERATURE REVIEWIn January 2021, the US Food and Drug Administration (FDA) approved a rapid infusion protocol, 8 which shortens the Ocrevus portion of the infusion visit from 3.5 hours to 2.0 hours (see Table 1 for full protocol). The use of this protocol could help to address the clinical problem identified above. To investigate the potential effects of the rapid protocol, a systematic review was conducted. The inclusion criteria for the search included the following: publication date after 2000 (with preference given to articles published in the past 5 years), English language, study population of patients receiving Ocrevus or other high-acuity infusions in an outpatient setting, and studies regarding impact of infusion times and/or shortened/rapid infusion protocols. Inclusion criteria also included the following outcomes of interest: patient safety (allergic reactions, infusion reactions, and ability to complete infusion), patient satisfaction (reported satisfaction level, cost for patient, anxiety/stress related to infusion, and

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Section: Results Of the Reviewmentioning

confidence: 88%

Effects of an Ocrevus Rapid Infusion Protocol: A Literature Review and Quality Improvement Project

Brandt

2023

Journal of Infusion Nursing

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“…infusions of rituximab have previously been administered at a dose of 375 mg/m 2 . Recently, rapid infusion of rituximab at doses ranging from 500–750 mg/m 2 were administered in a cohort of 11 patients with primary central nervous system lymphoma and no IRRs of any grade were observed during the 44 rapid rituximab infusions 31 . In our cohort, patients with CLL were treated with SDZ‐RTX‐chlorambucil or SDZ‐RTX‐venetoclax, both with rituximab at a dose of 500 mg/m 2 32,33 .…”

Section: Discussionmentioning

confidence: 95%

“…Recently, rapid infusion of rituximab at doses ranging from 500–750 mg/m 2 were administered in a cohort of 11 patients with primary central nervous system lymphoma and no IRRs of any grade were observed during the 44 rapid rituximab infusions. 31 In our cohort, patients with CLL were treated with SDZ‐RTX‐chlorambucil or SDZ‐RTX‐venetoclax, both with rituximab at a dose of 500 mg/m 2 . 32 , 33 Our data show that patients with CLL fulfilling our inclusion and exclusion criteria (in particular, lymphocytosis <5 × 10 9 /L and prior tolerance of a standard rituximab i.v.…”

Section: Discussionmentioning

confidence: 99%

Safety and tolerability of a 90‐minute rapid infusion of Sandoz biosimilar rituximab in B‐cell lymphoproliferative disorders in a real‐world setting

Muntañola

Arguiñano‐Pérez

Dávila

et al. 2022

Clinical Translational Sci

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Although rituximab is generally well-tolerated, infusion-related reactions (IRRs) are common with the initial dose when administered intravenously according to standard recommendations. To prevent IRRs, premedication and low-speed infusion rates have been recommended. Consequently, intravenous (i.v.) infusion of rituximab can become a labor-intensive process. Rapid i.v. rituximab infusion over 90 min has demonstrated a favorable safety profile for the second and subsequent infusions during the course of therapy. The aim of this study was to investigate the safety and tolerability of 90-min rapid infusion of Sandoz rituximab biosimilar (SDZ-RTX) for patients with CD20+ lymphoma or chronic lymphocytic leukemia (CLL). We retrospectively reviewed all patients with CD20+ lymphoma or CLL who received SDZ-RTX infusions in 90 min from July 2019 to July 2021 at seven Spanish hospitals. The primary end point was the incidence of IRRs. We identified 124 patients and 576 rapid administrations of SDZ-RTX, with an average of five rapid infusions per patient. Most rapid infusions of SDZ-RTX were in combination with CHOP/CHOP-like therapy (48.4%), followed by

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“…Interventions outlined in Table 1 provide practical recommendations which can be implemented to meet the needs of patients during the dynamics of a pandemic. 5–50…”

Section: Altering System Cancer Regimensmentioning

confidence: 99%

“…56 Rapid infusion protocols have also been described for daratumumab administered as a 90-minute infusion and bevacizumab over 10-minutes with no added safety signals. [25][26][27][28]34,36 To further reduce infusion times, various subcutaneous options have emerged that allow administration times of a few minutes. Rituximab hyaluronidase, trastuzumab hyaluronidase, and most recently, daratumumab hyaluronidase are subcutaneous injections that can be delivered in under 10 minutes.…”

Section: Extending Therapeutic Intervals and Minimizing Chair Timementioning

confidence: 99%

Clinical strategies for optimizing infusion center care through a pandemic

Hanna

Segal

Barlow

et al. 2020

J Oncol Pharm Pract

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The national pandemic resulting from the novel coronavirus, COVID-19, has made the delivery of care for patients with cancer a challenge. There are competing risks of mortality from cancer versus serious complications and higher risk of death from COVID-19 in immunocompromised hosts. Furthermore, compounding these concerns is the inadequate supply of personal protective equipment, decreased hospital capacity, and paucity of effective treatments or vaccines to date for COVID-19. Guidance measures and recommendations have been published by national organizations aiming to facilitate the delivery of care in a safe and effective manner, many of which, are permanently adoptable interventions. Given the critical importance to continue chemotherapy, there remains additional interventions to further enhance patient safety while conserving healthcare resources such as adjustments in medication administration, reduction in laboratory or drug monitoring, and home delivery of specialty infusions. In this manuscript, we outline how to implement these actionable interventions of chemotherapy and supportive care delivery to further enhance the current precautionary measures while maintaining safe and effective patient care. Coupled with current published standards, these strategies can help alleviate the numerous challenges associated with this pandemic.

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Rapid infusion rituximab is well tolerated in patients with primary CNS lymphoma

Cited by 4 publications

References 31 publications

Effects of an Ocrevus Rapid Infusion Protocol: A Literature Review and Quality Improvement Project

Effects of an Ocrevus Rapid Infusion Protocol: A Literature Review and Quality Improvement Project

Safety and tolerability of a 90‐minute rapid infusion of Sandoz biosimilar rituximab in B‐cell lymphoproliferative disorders in a real‐world setting

Clinical strategies for optimizing infusion center care through a pandemic

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