Update on rituximab

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Abstract
In 1997, the US Food and Drug Administration (FDA) approved rituximab for the treatment of low grade non-Hodgkin’s B cell lymphomas.9 Since that time, it has been used in over 500 000 patients with generally excellent tolerability. Largely through a series of investigator sponsored trials supported in part by Genentech (South San Francisco, CA), the use of rituximab has been extended to a much wider spectrum of B cell malignancies, and strikingly, to a variety of autoimmune diseases in which B cells have been thought to play a role (fig 1). So far, blinded, randomised controlled trials (RCTs) have been completed only for rheumatoid arthritis, with clear indications of efficacy. Published uncontrolled series for idiopathic thrombocytopenic purpura, polyneuropathy, systemic lupus erythematosus, and Wegener’s vasculitis, have given very suggestive signals of potential usefulness. In all, anecdotal information is available on some 30 autoimmune conditions (box 1).