title: Evaluation of the off-label usage of rituximab in a large teaching hospital in New South Wales.
abstract: A retrospective review of patients receiving rituximab off label in a large teaching hospital was conducted between July 2002 and January 2006. The indication, dosing regimen, efficacy and cost of rituximab were evaluated. Rituximab was prescribed for three clinical indications; acute organ transplant rejection, post-transplant lymphoproliferative disease and autoimmune disease. On average, 600 mg of rituximab was prescribed weekly for 4 weeks, costing the hospital $108,739.37. We suggest an initial approval for a limited number of doses with subsequent approval dependent on improvement in predefined clinical or biochemical end-points. Furthermore, we suggest an Australia-wide central database be established to enable delineation of the optimal dosing schedule, as well as monitoring of clinical outcome.
authors.affiliation: Department of Clinical Pharmacology, Westmead Hospital, Sydney, New South Wales, Australia.
authors.forename: R
authors.initials: R
authors.lastname: Sharma
authors.forename: L
authors.initials: L
authors.lastname: Koller
authors.forename: P
authors.initials: P
authors.lastname: Barclay
authors.forename: C
authors.initials: C
authors.lastname: Liddle
mesh_terms: D000911:Antibodies, Monoclonal / Q000191:economics / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived; D001315:Australia; D001327:Autoimmune Diseases / Q000188:drug therapy; D016527:Drug Costs; D006084:Graft Rejection / Q000188:drug therapy; D006801:Humans; D007166:Immunosuppressive Agents / Q000191:economics / Q000627:therapeutic use*; D008232:Lymphoproliferative Disorders / Q000188:drug therapy; D000069283:Rituximab
chemical_list: D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D007166:Immunosuppressive Agents; D000069283:Rituximab