Long-Term Safety of Rituximab (Risks of Viral and Opportunistic Infections)

Curr Rheumatol Rep. 2021 Jul 16;23(9):74. doi: 10.1007/s11926-021-01037-3.

Abstract

Purpose of review: We reviewed the current data on infections associated with rituximab use published over the last 5 years.

Recent findings: New literature was available on rates of serious infections, Hepatitis B reactivation and screening, and infection with Severe Acute Respiratory Syndrome Coronavirus 2. Rates of infection varied by study and population, however, higher risk of infection in patients with underlying rheumatologic diseases was seen in those who required a therapy switch, had a smoking history, and those undergoing retreatment who had a serious infection with their first course of therapy. With regards to HBV, the proportion of patients screened continues to be inadequate. Despite the upfront cost, HBV screening and prophylaxis were found to be cost effective. There is still limited data regarding COVID-19 severity in the setting of rituximab, however, rituximab, especially in combination with steroids, may lead to more severe disease and higher mortality.

Keywords: COVID-19; Hepatitis B; Infection; Rituximab; SARS-CoV-2.

Publication types

  • Review

MeSH terms

  • Antirheumatic Agents / therapeutic use*
  • Antiviral Agents / therapeutic use
  • COVID-19 / epidemiology*
  • Hepatitis B / diagnosis
  • Hepatitis B / drug therapy
  • Hepatitis B / epidemiology*
  • Hepatitis B / prevention & control
  • Humans
  • Immunocompromised Host
  • Latent Infection / diagnosis
  • Latent Infection / drug therapy
  • Latent Infection / epidemiology
  • Latent Infection / prevention & control
  • Mass Screening
  • Opportunistic Infections / epidemiology*
  • Risk
  • Rituximab / therapeutic use*
  • SARS-CoV-2
  • Virus Diseases / epidemiology

Substances

  • Antirheumatic Agents
  • Antiviral Agents
  • Rituximab