Sixty-minute infusion rituximab protocol allows for safe and efficient workflow
Emily Dotson1, Brooke Crawford2, Gary Phillips3
1The Ohio State Comprehensive Cancer Center-James Cancer Hospital, 460 W. 10th Ave., Columbus, OH, 43210, USA. Emily.Dotson@osumc.edu.
Insights
Subsequent rituximab infusions can be safely shortened to 60 minutes for non-Hodgkin
Area of Science:
- Oncology
- Pharmacology
- Clinical Medicine
Background:
- Rituximab is a key treatment for B cell non-Hodgkin's lymphoma (NHL).
- Infusion reactions are common with initial rituximab doses but lessen over time.
- A rapid infusion protocol was evaluated for safety and feasibility in an outpatient setting.
Purpose of the Study:
- To assess the safety and feasibility of a rituximab rapid infusion protocol.
- To evaluate the efficacy of shortened infusion times for subsequent rituximab doses.
- To determine the impact on patient safety and resource utilization.
Main Methods:
- Prospective study of 50 B cell NHL patients receiving their second rituximab dose.
- Rapid infusion protocol: 60 minutes without steroid premedication.
- Comparison of time savings and infusion-related reactions against standard protocol.
Main Results:
- No infusion-related reactions observed during rapid rituximab infusions (0%).
- Mean infusion time was 62.4 minutes, saving 94.2 minutes compared to standard.
- 100% nurse satisfaction reported with the rapid infusion protocol.
Conclusions:
- Subsequent rituximab infusions are safe when administered over 60 minutes without steroids.
- Rapid infusions reduce resource utilization and enhance nursing satisfaction in experienced centers.
- Appropriate patient screening is crucial for the successful implementation of rapid rituximab infusions.
Purpose:
Rituximab is a chimeric monoclonal antibody approved to treat B cell non-Hodgkin's lymphoma (NHL). Infusion reactions among NHL patients are common during the first exposure but decrease with subsequent infusions. We sought to assess the safety and feasibility of a rituximab rapid infusion protocol in the outpatient treatment area of a comprehensive cancer center.
Patients And Methods:
Patients with indolent and intermediate B cell NHL were invited to enroll in this prospective, single-institution study if they had received the first dose of rituximab according to the manufacturer-labeled standard titration schedule without grade >2 infusion reaction. The subsequent infusion proceeded without the use of steroid premedication at 100 mg/h administered over 15 min, with the remaining dose given over 45 min. Time savings between rapid infusion and standard titration were calculated.
Results:
Fifty patients received 60-min rituximab infusions during the second drug administration. No infusion-related reactions of any grade were observed with the rapid infusion protocol (0%, one-sided 97.5% CI 0-7.1%). The mean time for the rapid rituximab infusion was 62.4 min (95% CI 61.2-63.6). When compared to the standard second dose infusion recommendation, a mean time of 94.2 min (95% 90-98.4) was saved with rapid infusion. Nursing surveys demonstrated 100% satisfaction with the rapid infusion protocol.
Conclusions:
Subsequent rituximab infusions can be safely administered over 60 min and without steroid premedication in an experienced outpatient infusion center when patients are appropriately screened. The faster infusions can reduce resource utilization and increase nursing satisfaction.
Trial Registration:
NCT01206777.
More Related Videos
12:36Single-cell Analysis of Immunophenotype and Cytokine Production in Peripheral Whole Blood via Mass Cytometry
Published on: June 26, 2018
07:25In Vitro Methods for Comparing Target Binding and CDC Induction Between Therapeutic Antibodies: Applications in Biosimilarity Analysis
Published on: May 4, 2017