| Chronic Lymphocytic Leukemia

Rituxan vs Rituxan Hycela

Side-by-side clinical, coverage, and cost comparison for chronic lymphocytic leukemia.

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Safety signalsRituxan Hycela has a higher rate of injection site reactions vs Rituxan based on FDA-approved prescribing information

Coverage gaps3 major payers require step therapy for Rituxan Hycela but not Rituxan, including UnitedHealthcare

Category

Rituxan

Rituxan Hycela

At A Glance

RouteIV infusion

ClassAnti-CD20 monoclonal antibody

RouteSC injection

FrequencyEvery 3-4 weeks

ClassCD20-directed antibody

Indications

Lymphoma, Non-Hodgkin
Chronic Lymphocytic Leukemia
Rheumatoid Arthritis
Granulomatosis with polyangiitis
Microscopic Polyarteritis
Pemphigus Vulgaris
Acute lymphocytic leukemia

Lymphoma, Follicular
Diffuse Large B-Cell Lymphoma
Chronic Lymphocytic Leukemia

Dosing

Lymphoma, Non-Hodgkin 375 mg/m2 IV; weekly for 4 or 8 doses for relapsed/refractory low-grade or follicular NHL; Day 1 of each chemotherapy cycle for up to 8 doses for previously untreated follicular or DLBCL; every 8 weeks for 12 doses as single-agent maintenance.

Acute lymphocytic leukemia 375 mg/m2 IV for 6 total infusions in combination with LMB chemotherapy (two doses during each of the two induction courses, one dose during each of the two consolidation courses) for pediatric patients aged 6 months and older.

Chronic Lymphocytic Leukemia 375 mg/m2 IV the day prior to initiation of cycle 1 FC chemotherapy, then 500 mg/m2 on Day 1 of cycles 2-6 every 28 days.

Rheumatoid Arthritis Two 1,000 mg IV infusions separated by 2 weeks per course in combination with methotrexate; subsequent courses every 24 weeks (no sooner than 16 weeks); premedicate with methylprednisolone 100 mg IV 30 minutes prior to each infusion.

Granulomatosis with polyangiitis, Microscopic Polyarteritis Induction: 375 mg/m2 IV once weekly for 4 weeks with glucocorticoids; follow-up: two 500 mg IV infusions separated by 2 weeks, then 500 mg IV every 6 months based on clinical evaluation.

Pemphigus Vulgaris Two 1,000 mg IV infusions separated by 2 weeks in combination with a tapering course of glucocorticoids; then 500 mg IV at Month 12 and every 6 months thereafter or based on clinical evaluation.

Lymphoma, Follicular 1,400 mg/23,400 Units SC; for relapsed/refractory FL, once weekly for 3 or 7 weeks following an initial IV rituximab dose (4 or 8 weeks total); for previously untreated FL, on Day 1 of Cycles 2-8 of chemotherapy every 21 days, then maintenance every 8 weeks for 12 doses; for non-progressing FL after CVP, once weekly for 3 weeks every 6 months to a maximum of 16 doses.

Diffuse Large B-Cell Lymphoma 1,400 mg/23,400 Units SC on Day 1 of Cycles 2-8 of CHOP chemotherapy every 21 days for up to 7 cycles following an initial IV rituximab dose at Day 1, Cycle 1 (up to 6-8 cycles total).

Chronic Lymphocytic Leukemia 1,600 mg/26,800 Units SC on Day 1 of Cycles 2-6 in combination with fludarabine and cyclophosphamide every 28 days for 5 cycles following an initial IV rituximab dose at Day 1, Cycle 1 (6 cycles total).

Contraindications

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Drug Interactions

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637View drug interactions

Adverse Reactions

Most common (>=25%) Infusion-related reactions, fever, lymphopenia, chills, infection, asthenia (in NHL); infusion-related reactions, neutropenia (in CLL)

Serious Fatal infusion-related reactions, severe mucocutaneous reactions, hepatitis B reactivation with fulminant hepatitis, progressive multifocal leukoencephalopathy, tumor lysis syndrome, sepsis, cardiovascular events, renal toxicity, bowel obstruction and perforation

Postmarketing Prolonged pancytopenia, fatal cardiac failure, progressive multifocal leukoencephalopathy, severe mucocutaneous reactions, pyoderma gangrenosum, bowel obstruction and perforation, fatal bronchiolitis obliterans, fatal interstitial lung disease, posterior reversible encephalopathy syndrome

Most common (>=20%) Infections, neutropenia, nausea, constipation, cough, fatigue (FL); infections, neutropenia, alopecia, nausea, anemia (DLBCL); infections, neutropenia, nausea, thrombocytopenia, pyrexia, vomiting, injection site erythema (CLL).

Serious Mucocutaneous reactions, hepatitis B reactivation, progressive multifocal leukoencephalopathy, hypersensitivity and administration reactions, tumor lysis syndrome, infections, cardiac arrhythmias, renal toxicity, bowel obstruction and perforation.

Postmarketing Prolonged pancytopenia, fatal cardiac failure, uveitis, viral infections including PML, Kaposi's sarcoma progression, severe mucocutaneous reactions, pyoderma gangrenosum, bowel obstruction and perforation, fatal bronchiolitis obliterans, fatal interstitial lung disease.

Pharmacology

Rituximab is a chimeric murine/human IgG1 kappa monoclonal antibody that binds the CD20 antigen on pre-B and mature B-lymphocytes, mediating B-cell lysis via complement dependent cytotoxicity (CDC) and antibody dependent cell mediated cytotoxicity (ADCC).

Anti-CD20 chimeric murine/human IgG1 monoclonal antibody that binds the CD20 antigen on pre-B and mature B-lymphocytes, mediating B-cell lysis via complement dependent cytotoxicity (CDC) and antibody dependent cell mediated cytotoxicity (ADCC); combined with hyaluronidase human, which transiently depolymerizes subcutaneous hyaluronan to enhance rituximab absorption into systemic circulation.

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Most Common Insurance

Anthem BCBS

Rituxan