Safe and Efficacious Use of Low‐Dose Rituximab in Postpubertal Paediatric Patients With Immune Thrombocytopenia

TL;DR

This study shows that a lower dose of Rituximab is safe and effective for treating immune thrombocytopenia in older children.

Contribution

Demonstrates that a reduced Rituximab dose achieves similar results with fewer side effects in pediatric patients.

Findings

Six out of ten patients had a complete response to low-dose Rituximab.

Four responders maintained their response for over two years.

Only minor adverse events were reported with the lower dose.

Abstract

Rituximab, a CD20 monoclonal antibody, is used in chronic/refractory immune thrombocytopenia (ITP). Standard dosing is 375 mg/m2 weekly for 4 weeks alongside dexamethasone. A lower dose of Rituximab at 100 mg weekly demonstrates comparable efficacy that is well tolerated. This study evaluates lower‐dose Rituximab with dexamethasone in postpubertal pediatric ITP patients.

Patients treated with 100 mg weekly Rituximab for 4 weeks alongside dexamethasone at 10 mg/m2 on days 1–5 and 21–25 were assessed for response and safety.

Of the 10 patients treated, six responded completely, one partially and three showed no response. Four responders maintained their response over 2 years. One Rituximab‐related infusion reaction and one Dexamethasone‐related adverse event were reported.

Rituximab 100 mg weekly may be non‐inferior to 375 mg/m2 weekly for paediatric patients.

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