Date: 2001-05-16
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Contact
MHPD_DPSC
May 16, 2001

IMPORTANT DRUG SAFETY INFORMATION
Dear Health Professional,
Hoffmann-La Roche Ltd. would like to inform you of important updated serious adverse event information identified during post-market use of Rituxan® (rituximab). 'Rituxan' is indicated for the treatment of patients with relapsed or refractory low-grade or follicular, CD20 positive, B-cell non-Hodgkin's lymphoma. To date, approximately 100 000 patients world-wide have been treated with 'Rituxan'.
There have been 20 post-marketing reports worldwide of severe mucocutaneous reactions associated with the use of 'Rituxan'. Eight of these resulted in fatal outcomes. These reactions are variably described as Stevens-Johnson Syndrome, toxic epidermal necrolysis, paraneoplastic pemphigus, lichenoid dermatitis or vesiculobullous dermatitis. The onset of the reaction in the reported cases has varied from days to several months following 'Rituxan' exposure. No definitive predisposing factors have been identified. Patients experiencing a severe mucocutaneous reaction should interrupt treatment with 'Rituxan' and seek prompt medical evaluation. Skin biopsy of these reactions may help to establish a diagnosis and guide subsequent treatment. The safety of readministration of 'Rituxan' in these patients has not been determined.
Severe bullous skin reactions (including toxic epidermal necrolysis and pemphigus) were previously described in the ADVERSE EVENTS, Post Marketing Experience section of the Product Monograph. However, as a result of a review of these cases, the Warnings section of the Product Monograph will be revised to include information regarding severe mucocutaneous skin reactions.
Hoffmann-La Roche Ltd. is committed to providing you with the most up-to-date and accurate information regarding its products. Should you have any questions regarding the use of 'Rituxan', please contact our Drug Information and Safety Department at 1-888-ROCHE88 or through our Fax-on-Demand® system at 1-888-ROCHEFX or via the internet at www.rochecanada.com.
You can further our understanding of adverse events by reporting all cases to Hoffmann-La Roche Ltd. at 1-888-ROCHE88 or to Health Canada by telephone: (613) 957-0337, by fax: (613) 957-0335 or by email: cadrmp@hc-sc.gc.ca.
Sincerely,
HOFFMANN-LA ROCHE LTD.
Lorenzo Biondi, M.Sc.Phm.
V.P. Drug Regulation, Information and Quality
Hoffmann-La Roche Limited
2455 Medowpine Boulevard
Mississauga, Ontario L5N 6L7
Tel.(905) 542-5555
Fax (905) 542-7130