Guidance
Rituximab taken with glucocorticoids is recommended as a possible treatment for people with anti-neutrophil cytoplasmic antibody-associated vasculitis (that is, severely active granulomatosis with polyangiitis [also known as Wegener's granulomatosis] and microscopic polyangiitis) if:
- more treatment with cyclophosphamide would exceed the maximum amount of cyclophosphamide they can have or
- cyclophosphamide is not suitable for them or they cannot take it or
- they want to have children and treatment with cyclophosphamide may affect their fertility or
- the disease has stayed active or got worse after a course of cyclophosphamide lasting 3–6 months or
- the person has had cancer affecting the lining of the bladder and other parts of the urinary system.
What does this mean for me?
If you have anti-neutrophil cytoplasmic antibody-associated vasculitis as described above, and your doctor thinks that rituximab is the right treatment, you should be able to have the treatment on the NHS.
Rituximab should be available on the NHS within 3 months of the guidance being issued. If you are not eligible for treatment as described above but you are already being treated with rituximab within the NHS, you should be able to continue taking it until you and your doctor decide it is the right time to stop.
Your responsibility
The recommendations in this guidance represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, health professionals are expected to take this guidance fully into account, alongside the individual needs, preferences and values of their patients. The application of the recommendations in this guidance is at the discretion of health professionals and their individual patients and do not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.
Commissioners and/or providers have a responsibility to provide the funding required to enable the guidance to be applied when individual health professionals and their patients wish to use it, in accordance with the NHS Constitution. They should do so in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.