Study Finds Nurses Prefer IV Rituximab Administration in DLBCL Treatment

A recent study found a difference in preference when it came to the administration of rituximab in patients with blood cancer.

While patients tended to prefer subcutaneous administration of rituximab (Rituxan), more than half of nurses and other health care providers showed a preference for intravenous (IV) administration, according to recent research presented at the 62nd ASH Annual Meeting and Exposition.

“Among nursing staff, time savings, convenience, and perceived patient preference contributed to the positive experience [of giving rituximab intravenously],” study author Mitul Gandhi, MD, said in his presentation. Gandhi is a medical oncologist at the Virginia Cancer Specialists.

Rituximab has FDA-approved indications to treat follicular lymphoma (FL), diffuse large B-cell lymphoma (DLBCL), and chronic lymphocytic leukemia (CLL).

The researchers surveyed 29 patients (DLBCL, n = 12; FL, n = 13; CLL, n = 4) between July 2017 and April 2019. Average age was 69 years old, and the majority of patients had a preserved performance status and had received both IV and subcutaneous treatments.

Sixty-nine percent of patients said that they prefer subcutaneous rituximab. Common reasons cited included: less time spent in clinic (69% of respondents) and less emotional distress (41%).

Additionally, 62% of patients said that subcutaneous rituximab was very convenient, compared to 42% who responded the same about the IV method. Subcutaneous administration was shown to be easier, too, as only 28% of respondents said that it required caregiver assistance, compared to 45% of those with IV.

Conversely, in a survey of 36 nurses, 58% reported that they prefer giving rituximab via IV, citing that it saves time, it’s convenient, and patients prefer it. Most (80%) of nurses said that they spend 1.5 to over 2 hours monitoring IV rituximab, and more than half 52% said that 1.5 to 2 hours could be saved with subcutaneous administration.

Regarding nurse characteristics, the majority were younger than 65 years old, had a year or more of clinical experience, and had a familiarity with both the IV and subcutaneous methods of giving rituximab.

“In conclusion, even though our study was limited by a small sample size, the majority of surveyed patients and nurses expressed a preference of subcutaneous rituximab or intravenous rituximab, with reduced clinic time as the main motivation for this preference,” Gandhi said.

So, nurses and other clinicians should discuss patient preferences – as well as the pros and cons of each method of administration – with their patients before deciding on a treatment regimen.

“This real-word data provides useful information regarding the administration of subcutaneous rituximab in a community oncology setting,” Gandhi said.