Rituxan vs. Tysabri for Rheumatoid Arthritis and Crohn's Disease: Important Differences and Potential Risks.

Key takeaways

Rituxan (rituximab) and Tysabri (natalizumab) are both monoclonal antibodies used to treat different conditions, but they have some key differences. Rituxan (rituximab) is used for certain blood cancers like non-Hodgkin lymphoma and chronic lymphocytic leukemia, as well as autoimmune conditions such as rheumatoid arthritis. It works by targeting B cells in the immune system. Tysabri (natalizumab), on the other hand, is used to treat multiple sclerosis (MS) and Crohn's disease (CD) by blocking cells that cause inflammation. Rituxan (rituximab) infusions can take several hours and may be needed as infrequently as every six months, whereas Tysabri (natalizumab) is given once a month and takes about an hour. Both medications can cause serious side effects, but Tysabri (natalizumab) requires enrollment in the TOUCH Prescribing Program due to the risk of a severe brain infection called progressive multifocal leukoencephalopathy (PML).

Rituxan

(rituximab)

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Tysabri

(natalizumab)

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Summary for Rituxan

Prescription only

Rituxan (rituximab) is a monoclonal antibody. It treats certain types of blood cancers (e.g., non-Hodgkin lymphoma) and autoimmune conditions (e.g., rheumatoid arthritis) by targeting specific immune cells. Rituxan (rituximab) is given as an infusion through the vein (IV), typically at an infusion center. Your oncologist will give you premedications before each dose to lower the risk of serious infusion-related reactions. Other possible side effects of this medication include rash and weakness. Rituxan (rituximab) is available as many different brands (or biosimilars), but they don't all treat the same conditions.

Indications for Rituxan

Blood cancers

Certain types of CD20-positive non-Hodgkin’s lymphoma (NHL) in adults and children ages 6 months and older
CD20-positive chronic lymphocytic leukemia (CLL) in adults

Autoimmune conditions

Moderate to severe rheumatoid arthritis (RA) in adults
Granulomatosis with polyangitis (GPA) and microscopic polyangitis (MPA) in adults and children ages 2 years and older
Moderate to severe pemphigus vulgaris in adults

Pros and Cons for Rituxan

Pros

Works in a more targeted, specific way than chemotherapy
Might only need a dose once every 6 months for certain conditions
Doesn’t typically cause hair loss

Cons

Can cause serious infusion-related reactions
Each infusion can last over 3 hours, so can be inconvenient
Higher risk of infections can last a year after your last dose (sometimes longer)

Common Side Effects for Rituxan

Fever (53%)
Lower white blood cell counts (up to 48%)
Chills (33%)
Infection (31%)
Weakness (26%)
Nausea (23%)
Headache (19%)
Night sweats (15%)
Rash (15%)

Please note: Side effects listed were reported by people who took Rituxan (rituximab) alone for NHL in clinical studies.

Warnings for Rituxan

Infusion-related reactions
Serious skin reactions
Hepatitis B reactivation
Progressive multifocal leukoencephalopathy
Tumor lysis syndrome
Serious infections
Serious heart problems
Kidney problems
Gut blockage and tears
Vaccines
Harm to unborn baby
Combination treatment for people with autoimmune conditions

Summary for Tysabri

Prescription only

Tysabri (natalizumab) is an injectable medication used to treat relapsing forms of multiple sclerosis (MS) in adults. It can also treat moderate-to-severe Crohn's disease (CD) in adults. It works as an integrin antagonist to help lower inflammation in the body. Tysabri (natalizumab) is given by a healthcare professional as an infusion into a vein once a month. Common side effects include headache and fatigue. Because it has a risk of serious infections, you must enroll in the Tysabri TOUCH Program before starting treatment.

Indications for Tysabri

Relapsing forms of multiple sclerosis (MS)
Moderate-to-severe Crohn's disease (CD) when other treatments haven't worked well

Pros and Cons for Tysabri

Pros

Infusions are once every month
Can help reduce relapses in MS
An option for Crohn's disease when other treatments haven't worked well

Cons

Must be given by a healthcare professional in a healthcare setting
Raises your risk of serious infection
Only FDA approved for adults

Common Side Effects for Tysabri

Headache (38%)
Fatigue or feeling very tired (27%)
Urinary tract infection (21%)
Joint pain (19%)
Depression (19%)
Lower respiratory tract infection (17%)
Pain in arm or leg (16%)
Rash or other skin irritation (up to 12%)
Stomach discomfort (11%)
Diarrhea (10%)

Warnings for Tysabri

Risk of a brain infection leading to progressive multifocal leukoencephalopathy (PML)
Risk of other infections
Liver problems
Allergic reaction or infusion reaction
Low platelet levels
Other lab changes