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rituximab (Usmal / BCD020 / AcellBia)

✓ Approved

Grupo Biotoscana · MS4A1 · Monoclonal Antibodies

What is rituximab?

rituximab is a monoclonal antibodies developed by Grupo Biotoscana. It is approved for therapeutic indications via injectable (others) or intracerebral/cerebroventricular injection or intravenous (iv) or subcutaneous injection.

Drug Profile

Brand NamesUsmal, BCD020, AcellBia
CompanyGrupo Biotoscana
Drug ClassMonoclonal Antibodies, Antibody
Molecular TargetMS4A1
RouteInjectable (Others), Intracerebral/cerebroventricular Injection, Intravenous (IV), Subcutaneous Injection
StatusApproved
Sources: ClinicalTrials.gov, Grupo Biotoscana

Mechanism of Action

Molecular Targets

rituximab acts on 1 molecular target:

MS4A1membrane spanning 4-domains A1 (S7, B1)
Want deeper analysis?Noah AI can explain complex mechanisms and compare to similar drugs.

Therapeutic Indications

rituximab is developed for 7 unique indications across 4 therapeutic areas.

Therapeutic AreaConditionPhase
Neoplasms benign, malignant and unspecified (incl cysts and polyps)B-cell lymphoma✓ Approved
Neoplasms benign, malignant and unspecified (incl cysts and polyps)Chronic lymphocytic leukaemia✓ Approved
Neoplasms benign, malignant and unspecified (incl cysts and polyps)Non-Hodgkin's lymphoma✓ Approved
Musculoskeletal and connective tissue disordersRheumatoid arthritis✓ Approved
Vascular disordersMicroscopic polyangiitisPreclinical

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Related Research Articles

PubMedCureus2026-06-09

Complex Challenges in ANCA-Associated Vasculitis: A Case of COVID-19, Cytomegalovirus Pneumonitis, and Hemorrhagic Cholecystitis Following Rituximab Therapy.

Ezzy Fatema F, Ismail Dina D, Reyes Castro Tiago T, Chao Chen C et al.

Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a rare autoimmune disease with significant infectious and hemorrhagic risks during immunosuppressive therapy. We describe an 81-year-old woman with perinuclear ANCA (p-ANCA)-associated vasculitis complicated by acute respiratory distress syndrome from concurrent COVID-19 and CMV pneumonitis following rituximab induction. Her course was further complicated by hemorrhagic cholecystitis, a rare bleeding manifestation, requiring percutaneous intervention. Careful adjustment of immunosuppression was necessary due to severe infections. This case highlights the complexity of managing AAV amid severe infections and rare hemorrhagic complications, emphasizing the need for vigilant monitoring and individualized therapy.

PMID 42261503
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PubMedFortschritte der Neurologie-Psychiatrie2026-06-09

[Rare very late-onset neuromyelitis optica].

Maximov Maxim M, Rodriguez Lago Alberto A

Neuromyelitis optica (NMO) and its related forms, collectively referred to as neuromyelitis optica spectrum disorders (NMOSD), are rare but often severe autoimmune diseases of the central nervous system (CNS). NMOSD predominantly affects women, most commonly between the ages of 30 and 40 years. Aquaporin-4 antibodies (AQP4-IgG) are detectable in approximately 80% of patients with NMOSD.The cardinal clinical manifestations include transverse myelitis, optic neuritis (ON), as well as brainstem and diencephalic involvement.Most NMOSD cases follow a relapsing-remitting course without progression between relapses. NMOSD relapses are often severe and result in incomplete remission and permanent disability. Monophasic courses are rare. We report the case of an 86-year-old female patient who presented with subacute occipital headache and right leg hemiparesis, which progressed to tetraparesis. Magnetic resonance imaging (MRI) revealed a longitudinally extensive transverse myelitis (LETM) from cervical vertebrae C1 to C5. Cerebrospinal fluid (CSF) analysis demonstrated mild pleocytosis, elevated protein levels, and the presence of oligoclonal bands. Aquaporin-4 antibody testing returned strongly positive, confirming the diagnosis of NMOSD. The disease was classified as very late-onset NMOSD (VLO-NMOSD). Treatment with high-dose intravenous methylprednisolone for five days resulted in symptom improvement. Approximately eleven weeks post-discharge, therapy with the anti-CD20 monoclonal antibody rituximab was initiated. The patient's condition remained stable under maintenance therapy, with no further relapses. NMOSD can manifest even in very advanced age, beyond 75 years. Given the patient's initial presentation with right leg hemiparesis, advanced age, and multiple vascular risk factors, NMOSD was not initially suspected. The accompanying occipital headaches often exhibit migraine-like characteristics.Treatment with intravenous methylprednisolone resulted in symptom improvement, and rituximab was well tolerated.

PMID 42259378
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PubMedClinical transplantation and research2026-06-09

Anti-vimentin antibodies-associated recurrent antibody-mediated rejection after kidney transplantation: a case report.

Jang Kyu Won KW, Choi Byung Hyun BH, Kim Il Young IY

Acute antibody-mediated rejection without detectable human leukocyte antigen donor-specific antibodies has been increasingly reported. We describe a case of antibody-mediated rejection associated with pre-existing anti-vimentin antibodies in a kidney transplant recipient with no detectable human leukocyte antigen donor-specific antibodies on Pretransplant evaluation. A non-human leukocyte antigen antibody panel identified anti-vimentin antibodies before transplantation. Despite treatment with methylprednisolone, plasmapheresis, intravenous immunoglobulin, and rituximab, antibody mediated rejection recurred and led to progressive graft dysfunction. This case underscores the importance of expanded pretransplant screening for preformed autoantibodies, particularly in recipients receiving long-term hemodialysis, and highlights the potential need for more intensive monitoring and management in patients with anti-vimentin antibodies.

PMID 42260925
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PubMedSAGE open medical case reports2026-06-09

Healthy birth after chemotherapy for diffuse large B-cell lymphoma with superior vena cava syndrome in late pregnancy: A case report.

Liang Haiyan H, Xia Tian T, Wu Guocai G

A young woman in late pregnancy (31 weeks of gestation) was diagnosed with diffuse large B-cell lymphoma, presenting with bilateral cervical and upper thoracic paratracheal lymphadenopathy that led to superior vena cava syndrome. Her clinical presentation included progressively worsening dyspnea and an inability to lie flat. The initial treatment consisted of a combination of rituximab, cyclophosphamide, pirarubicin, vincristine, and dexamethasone and etoposide chemotherapy. After tumor shrinkage and symptomatic improvement, the pregnancy was terminated via cesarean section, yielding a healthy neonate. Although the patient was classified as high-intermediate risk, consolidated autologous hematopoietic stem cell transplantation was not performed due to her young age. Notably, NKG2C+ natural killer cells-potentially representing antitumor reactive lymphocytes-were detected during the initial treatment but eventually became undetectable. Overall, the patient achieved a satisfactory and notable treatment outcome.

PMID 42261338
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PubMedNeuromuscular disorders : NMD2026-06-09

Relevance of anti-Ku antibodies in Ku-positive myositis with a necrotizing myopathy-like phenotype: a pediatric case report.

Saito Takamasa T, Shigemura Tomonari T, Yamanaka Ai A, Yabe Manami M et al.

Muscle-specific antibodies against signal recognition particle (SRP) and 3‑hydroxy-3-methylglutaryl-CoA reductase (HMGCR) are established pathogenic factors in immune-mediated necrotizing myopathy (IMNM), and their titers are generally considered to correlate with disease activity. In contrast, the relevance of anti-Ku antibodies, which are myositis-associated autoantibodies typically detected in overlap syndromes and also found in a subset of IMNM patients lacking anti-SRP and anti-HMGCR antibodies, remains unclear. We report a 13-year-old girl with steroid-resistant Ku-positive myositis with necrotizing myopathy-like pathology who was exclusively positive for anti-Ku antibodies. Rituximab was introduced after failure of multiple immunosuppressive therapies and resulted in marked clinical improvement, accompanied by normalization of serum creatine kinase levels, improvement on muscle magnetic resonance imaging, and recovery of Childhood Myositis Assessment Scale scores. Immunostaining showed relatively enhanced nuclear Ku expression in the sarcolemmal region of the patient's muscle fibers compared with control muscle. However, anti-Ku antibody titers remained persistently elevated despite sustained clinical remission. These findings suggest that anti-Ku antibody titers did not correlate with disease activity in this patient, indicating that anti-Ku-associated myositis may differ from anti-SRP- or anti-HMGCR-associated myopathies.

PMID 42259186
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PubMedCureus2026-06-09

Epstein-Barr Virus (EBV)-Positive Diffuse Large B-cell Lymphoma Masquerading As Lupus Pneumonitis in a Young Woman With Systemic Lupus Erythematosus: A Diagnostic Odyssey.

Anya Onyekachi O OO, Mosallaei Shariff S, Wysham Nicholas N

Patients with systemic lupus erythematosus (SLE) are at increased risk for lymphoma compared to the general population. While pulmonary manifestations are common in SLE, diffuse micronodular patterns can resemble infection, granulomatous disease, or malignancy, making diagnosis challenging. A 21-year-old woman with childhood-onset SLE (class IV lupus nephritis) on mycophenolate mofetil and hydroxychloroquine presented with progressive dyspnea and diffuse bilateral pulmonary micronodularity. Initial bronchoscopy and biopsy showed non-specific perivascular inflammation, negative for malignancy or infection. She initially responded to steroids with near-complete radiographic resolution. Over the next nine months, however, she developed recurrent pulmonary nodules unresponsive to increased immunosuppression. Repeat bronchoscopy revealed necrotizing granulomatous inflammation without identifiable organisms. Her condition progressed to respiratory failure, necessitating a surgical lung biopsy. Video-assisted thoracoscopic surgery (VATS) wedge resection identified Epstein-Barr virus (EBV)-positive diffuse large B-cell lymphoma arising in immune deficiency/dysregulation, with an EBV PCR of 25,500 IU/mL. Postoperatively, she developed acute respiratory failure requiring extracorporeal membrane oxygenation (ECMO) and hemophagocytic lymphohistiocytosis (HLH). She completed six cycles of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) chemotherapy. End-of-treatment PET/CT showed persistent hypermetabolic pulmonary nodules (Deauville score 5), and she is now being evaluated for chimeric antigen receptor (CAR) T-cell therapy. This case highlights the challenge of distinguishing lymphoproliferative disorders from autoimmune lung disease in immunosuppressed SLE patients. Initial steroid responsiveness does not rule out malignancy. Clinicians should maintain a high suspicion for lymphoma in SLE patients with atypical or refractory pulmonary symptoms, especially those on chronic immunosuppression.

PMID 42261517
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