Infusion-Related Reactions with Truxima (Rituximab)

Risk of Infusion Reactions

• Up to 77% of patients may experience reactions during the first rituximab infusion, with severe reactions occurring in approximately 10% of cases, according to the American Society of Clinical Oncology 1, 2
• Fatal infusion reactions have been reported and are characterized by hypoxia, pulmonary infiltrates, respiratory distress, myocardial infarction, ventricular fibrillation, and cardiogenic shock, as documented by the American College of Chest Physicians 3, 4

Management of Reactions

• For mild to moderate reactions (Grade 1-2), the American Society of Clinical Oncology recommends stopping or slowing the infusion rate, providing symptomatic treatment, and resuming at half the previous rate after symptoms resolve 1, 2
• For severe reactions (Grade 3-4), the American Society of Clinical Oncology recommends stopping the infusion immediately, providing aggressive symptomatic treatment, and permanently discontinuing for Grade 4 reactions 1, 2

Premedication Recommendations

• The American Society of Clinical Oncology recommends that all patients receive premedication with antihistamine (e.g., diphenhydramine) 1

Conclusion for Clinical Practice

• Given the significant risk of infusion reactions (77% for first infusion) and the potential for severe or even fatal outcomes, observation during and after Truxima infusion is required, as recommended by the American Society of Clinical Oncology 1