Rituxan Possible Link to Brain Infection Death in Arthritis Patient
Posted Jun 05 2010 7:46pm
The U.S Food and Drug Administration (FDA) has reported that an arthritis patient that had been prescribed Rituxan has died of a rare viral infection more that a year and a half after discontinuing use of the drug. Rituxan, marketed in the U.S. by Biogen Idec and Genetech, is approved to treat non-Hodgkin’s lymphoma and rheumatoid arthritis.
There are previously reported cases of the infection in patients taking Rituxan for unapproved uses, including lupus. However, according to the FDA this is the first time that the infection has been reported in a patient taking the drug to treat arthritis.
The disease, called progressive multifocal leukoencephalopathy, or PML, is very rare and is most often found in patients with severely impaired immune systems such as those with AIDS or taking immunosuppressive medications. It is caused by a virus for which 86% of the general population has antibodies.
Node of Ranvier
PML gradually destroys the myelin sheath that covers the axons which impairs the transmission of nerve impulses. Axons are in effect the primary transmission lines of the nervous system. Bundles of axons help to make up nerves. PML results in paralysis, impaired speech, vision loss and cognitive deterioration. There is no known cure and patients generally die within 4 months.
“The patient had a number of confounding factors that make it difficult to assess the potential role, if any, that Rituxan exposure may have played,” according to a Genentech spokeswoman.
The FDA’s web site reports that the patient was undergoing chemotherapy and radiation treatment for cancer in the months before she developed the infection.