STUDY THE PREVALENCE OF NON-HEMATOLOGICAL SIDE EFFECTS OF RITUXIMAB IN RIYADH, SAUDI ARABIA

Background: Rituximab (RTX) therapy has been used for hematological malignancies and autoimmune diseases for a long time, and its efficacy and safety are well documented. In spite of conflicting results from clinical trials regarding the association between RTX and infections, an increased incidence of infections or toxixity has recently been reported among patients receiving RTX for lymphomas. To date, there hasn't been any clinical experience linking RTX with different non-hematological side effects.

Objectives: To investigate the prevalence of non-hematological side effects in in patients and outpatients receiving RTX in Riyadh, Saudi Arabia. 

Methods: A retrospective cross-sectional study was conducted from July 2020 to August 2021 at King Saud University Medical City (KSUMC), Riyadh, KSA. All consecutive patients who attended the KSUMC between July 2020 to August 2021 and referred with autoimmune or different types of cancer disease were included in this study.

Results: RTX was commonly prescribed for different types of malignancies and autoimmune diseases. Non-hematological adverse reaction has been evaluated up to 1 year in patients who had been treated with RTX. The most common indications for RTX were DLBCL (36%), B cell lymphoma (20.2%), non-Hodgkin's lymphoma (NHL) (15.7%), chronic lymphocytic leukemia (10.1%), and Hodgkin's lymphoma (7.9%). An analysis of the association between RTX and infection among patients with hematological malignancies and autoimmune disorders was done. The most frequent adverse event was infection, infusion-related reactions. Infection rate of 34.8% was observed during the study and the infected patients had glomerulonephritis (9%), hepatitis B infection (6.7%) and renal toxicity (5.6%). Study results showed that RTX was well tolerated after one or more courses. Multiple courses did not result in increased serious infections.

Conclusion: Data from this study indicate that RTX is a commonly used for autoimmune and cancers diseases with potential beneficial effects. Although RTX has a wide range of non-hematological adverse reaction, its well-tolerated therapy for autoimmune diseases. To clarify the association between RTX and infection, further research is needed.

Keywords:

 Rituximab, non-hematological, autoimmune, infections, Hodgkin's lymphom