UCL logo

UCL Discovery

UCL home » Library Services » Electronic resources » UCL Discovery

Rituximab pharmacokinetics during the management of acute idiopathic thrombotic thrombocytopenic purpura

McDonald, V; Manns, K; Mackie, IJ; Machin, SJ; Scully, MA; (2010) Rituximab pharmacokinetics during the management of acute idiopathic thrombotic thrombocytopenic purpura. J THROMB HAEMOST , 8 (6) 1201 - 1208. 10.1111/j.1538-7836.2010.03818.x.

Full text not available from this repository.

Abstract

Background: Increasingly, patients with acute, idiopathic, antibody mediated thrombotic thrombocytopenic purpura (TTP) are being treated with rituximab to achieve a durable remission, however, there is the potential that it is removed by plasma exchange (PEX). Objectives: To look at the pharmacokinetics and pharmacodynamics of rituximab in patients with acute idiopathic TTP undergoing PEX. Patients and methods: Patients who received rituximab for acute idiopathic TTP (group 1, n = 30) and a control group ( group 2, n = 3) of TTP patients in remission receiving rituximab electively as maintenance were included. Rituximab levels were measured before/after each infusion, before/after PEX and in follow-up. ADAMTS-13 activity, anti-ADAMTS-13 IgG and CD19% were measured to assess response. Results: The median number of PEX to remission after rituximab was 10 (range 4-25). In group 1 there was no significant incremental rise in the peak serum rituximab level until dose 4. Trough levels were lower in patients who had had PEX since their last rituximab infusion. In the control group, there was an incremental rise in the peak serum rituximab level and all patients had detectable trough levels. The median fall in rituximab per PEX was 65%. All patients achieved CD19 < 1%. In group 1, the median time to undetectable rituximab was 5 months (range 0-12 months) and to B cell return was 7 months (range 3-24 months). ADAMTS-13 increased and anti-ADAMTS-13 fell after therapy. There were three deaths and two relapses in group 1. Relapse was not temporally related to B cell return.

Type: Article
Title: Rituximab pharmacokinetics during the management of acute idiopathic thrombotic thrombocytopenic purpura
DOI: 10.1111/j.1538-7836.2010.03818.x
Keywords: ADAMTS-13, pharmacodynamics, pharmacokinetics, plasma exchange, rituximab, TTP, FACTOR-CLEAVING PROTEASE, HEMOLYTIC UREMIC SYNDROME, ADAMTS13 ACTIVITY, IGG ANTIBODIES, B-CELLS, AUTOANTIBODIES, FEATURES, CD20, MICROANGIOPATHIES, ASSOCIATION
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute > Research Department of Haematology
URI: http://discovery.ucl.ac.uk/id/eprint/129806
Downloads since deposit
0Downloads
Download activity - last month
Download activity - last 12 months
Downloads by country - last 12 months

Archive Staff Only

View Item View Item