Rituximab in combination with glucocorticoids for treating anti-neutrophil cytoplasmic antibody-associated vasculitis

Rituximab, in combination with glucocorticoids, is recommended as an option for inducing remission in adults with anti-neutrophil cytoplasmic antibody [ANCA]-associated vasculitis (severely active granulomatosis with polyangiitis [Wegener's] and microscopic polyangiitis), only if:

• further cyclophosphamide treatment would exceed the maximum cumulative cyclophosphamide dose or

• cyclophosphamide is contraindicated or not tolerated or

• the person has not completed their family and treatment with cyclophosphamide may materially affect their fertility or

• the disease has remained active or progressed despite a course of cyclophosphamide lasting 3–6 months or

• the person has had uroepithelial malignancy.

People currently receiving treatment initiated within the NHS with rituximab that is not recommended for them by NICE in this guidance should be able to continue treatment until they and their NHS clinician consider it appropriate to stop.