In what circumstance would Rituximab be used as a first line therapy?
Generally, Rituximab would be considered appropriate as a first line therapy in the same circumstances that Ocrevus would be considered as first line therapy. The difference is that Ocrevus is specifically approved by the FDA for treatment of relapsing and primary progressive MS and easier in most circumstances to get approved by insurance carriers for these indications. The exception is Kaiser Permanente insured patients, where Rituximab is part of their formulary for MS treatment.
Revere (Rip) Kinkel MD
Professor of Clinical Neurosciences
Director of the Multiple Sclerosis Program
Clinical Neurosciences Director
University of California San Diego