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Obinutuzumab
Obinutuzumab is a medicine that is usually used to treat certain types of cancer. It belongs to a class of medications called type II anti-CD20 monoclonal antibodies. Obinutuzumab also offers an alternative to current immunosuppressive therapies and other monoclonal antibodies for difficult-to-treat rare, protein spilling kidney diseases.
Why is Obinutuzumab Needed for Rare Kidney Disease (RKD) Patients?
There are currently few FDA approved therapies for RKD patients and each patient responds differently to each medication. Some patients do not respond to other treatment options. Successful Obinutuzumab treatment can help you lower the amount of protein you are spilling into your urine, go into complete remission and allow you to stop taking other medications without substantially increasing the risk of infections and other serious side effects.
How Does Obinutuzumab Work?
Obinutuzumab reduces the number of harmful antibodies called autoantibodies (ANCA) that a body produces by targeting and destroying B-cells. ANCAs attack healthy tissue and cells and are produced by B-cells. The autoantibodies target specific white blood cells called neutrophils, and the ANCAs cause neutrophils to stick and clump to the walls of small blood vessels in different tissues and organs of the body. This clumping leads to inflammation.
Obinutuzumab decreases the number of B-cells by targeting those that have a specific marker on their cell surface called CD20. It is thought that interfering with B-cell function can disrupt ANCA production as well. As a type 2 anti-CD20 monoclonal antibody it differs from Rituximab and is sometimes effective in rituximab-resistant patients.
*Note: The decision to prescribe a medication is the responsibility of your physician/primary care provider based on his/her evaluation of your condition. The above is meant for informational purposes only. Discuss this information and all information about drugs/medications with your physician before starting or stopping any medication.
Frequently Asked Questions
Obinutuzumab is a liquid given intravenously (IV) in a hospital or a clinic. Patients are often pre-medicated with Benadryl to ward off allergic reactions. The medication is given slowly over a period of several hours. While receiving Obinutuzumab, a patient is closely monitored for adverse side effects and can expect to have blood pressure and other vitals monitored very closely.
Obinutuzumab can cause some reactions during the time the drug is being given or shortly after. These are called infusion reactions. They will usually occur with the first dose and are less common with later doses. To help prevent this type of reaction, acetaminophen (Tylenol) and diphenhydramine (Benadryl) are given before rituximab. However, tell your doctor immediately if you experience a reaction during the infusion or within 24 hours afterwards, such as:
- Chills or fever
- Nausea (upset stomach) or vomiting (throwing up)
- Swelling of the tongue or throat
- Hives (raised red spots on the skin) or itching
- Headache
- Trouble breathing
- Dizziness or lightheadedness
- Flushing (feeling warm and turning red)
- Fatigue
- Blurred vision
Other less common side effects are listed below. Call your doctor right away or go to the emergency room if you experience the following side effects:
- Abdominal pain or stomach pain
- Black, tarry stools
- Bleeding gums
- Blood in the urine or stools
- Chest pain
- Cough
- Fatigue
- Joint pain, stiffness or swelling
- Lower back or side pain
- Painful or difficult urination
- Pale skin
- Trouble breathing or swallowing
- Skin reactions
- Unusual bruising or bleeding
For a complete list of possible side effects visit the manufacturers website.
Check with your doctor before taking any other medicines (prescription, non-prescription, herbal, or natural products). Before having any operation or procedure, inform your doctor or dentist that you are taking Obinutuzumab.
Obinutuzumab can lower the number of white blood cells in the blood temporarily, which increases chances of getting an infection. Your doctor should do regular blood tests to monitor your blood counts and test for other side effects such as neutropenia.
You should not receive any immunizations (vaccines) without your doctor’s approval while being treated with Obinutuzumab.
Unrecognized Hepatitis B infection may become worse during Obinutuzumab treatment, so you may be advised to get a Hepatitis B test.
Other medications may affect response to Obinutuzumab. Check with your doctor to discuss which medications you are currently taking.
