Name of the Procedure:

Injection, rituximab-pvvr, biosimilar (Ruxience), 10 mg (HCPCS Code: Q5119)

Summary

Rituximab-pvvr (Ruxience) is a biosimilar medication used for infusion into the bloodstream to treat certain medical conditions. This procedure involves injecting a specific dose of Ruxience to help the immune system manage these conditions, usually performed in a hospital or outpatient clinic setting.

Purpose

This treatment is primarily used to address autoimmune diseases, certain types of cancers such as non-Hodgkin's lymphoma, and other conditions that involve the body's immune system functioning abnormally. The goal is to reduce disease symptoms, manage immune system responses, and improve the patient’s quality of life.

Indications

• Non-Hodgkin's lymphoma
• Chronic lymphocytic leukemia
• Rheumatoid arthritis
• Certain autoimmune diseases like granulomatosis with polyangiitis and microscopic polyangiitis

Patient criteria:

• Diagnosis of one of the conditions listed
• Assessment and recommendation by a healthcare provider

Preparation

• The patient may need to undergo blood tests and imaging studies before the first infusion.
• Pre-medication, such as antihistamines or corticosteroids, may be administered to minimize allergic reactions.
• Fasting is not usually required for this procedure.

Procedure Description

1. Patient arrives at the infusion center.
2. A healthcare provider reviews the patient's medical history and prepares the necessary dose of Ruxience.
3. An intravenous (IV) line is inserted into a vein in the patient's arm.
4. Pre-medications are administered if prescribed.
5. Ruxience is infused slowly through the IV line over several hours.
6. The healthcare provider monitors the patient for any adverse reactions during and after the infusion.

Duration

The infusion typically takes several hours, often around 3-6 hours, depending on the specific treatment protocol and patient's response.

Setting

The procedure is performed in a hospital setting, outpatient clinic, or specialized infusion center.

Personnel

• Registered Nurse or Infusion Nurse
• On-site Physician or Specialist
• Pharmacist (for medication preparation)
• Medical Assistant or Support Staff (for patient monitoring and assistance)

Risks and Complications

Common risks:

• Allergic reactions (rash, itching, shortness of breath)

• Infusion-related reactions (fever, chills)

  Rare but serious risks:

• Severe allergic reaction called anaphylaxis
• Infections due to immune suppression
• Hepatitis B reactivation in patients with a history of the virus

Benefits

• Reduction in symptoms related to autoimmune diseases and cancer
• Improved management of disease progression
• In some cases, remission of disease symptoms

Benefits may start to be realized within a few weeks to months post-treatment.

Recovery

• Patients are usually observed for a period post-infusion for any immediate reactions.
• They may resume normal activities the next day, barring any specific medical advice or complications.
• Follow-up appointments are necessary to monitor the effectiveness and any delayed side effects of therapy.

Alternatives

• Alternative chemotherapy agents for cancer
• Other biologic response modifiers or disease-modifying antirheumatic drugs (DMARDs) for autoimmune conditions
• Pros and cons should be discussed with a healthcare provider to determine the best treatment plan based on individual patient profiles.

Patient Experience

During the procedure:

• Patients might feel discomfort from the IV insertion.
• Some may experience mild reactions such as chills, fever, or nausea.
• Pain management and comfort measures are provided as needed.

After the procedure:

• Mild fatigue and slight discomfort at the infusion site are common.
• Patients should report any severe or unusual symptoms to their healthcare provider immediately.

Pain and anxiety related to the infusion can be managed with appropriate medications and support from the healthcare team.