Castleman Disease Medication

Updated: Feb 01, 2018
  • Author: Neetu Radhakrishnan, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Medication

Medication Summary

Siltuximab is the only agent approved by the US Food and Drug Administration for use in Castleman disease—specifically, for idiopathic multicentric Castleman disease. Rituximab and tocilizumab have been used off-label for multicentric Castleman disease.

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Immunomodulators

Class Summary

Agents that decrease IL-6 production or actions are emerging for MCD.

Siltuximab (Sylvant)

Siltuximab is a monoclonal antibody that binds IL-6 and prevents the binding of IL-6 to both soluble and membrane-bound IL-6 receptors. It is approved by the FDA with an indication for multicentric Castleman disease in patients who are negative for HIV and human herpesvirus-8.

Tocilizumab (Actemra)

Tocilizumab is an IL-6 receptor antagonist. It has been used off-label for multicentric Castleman disease.

Rituximab (Rituxan)

Rituximab is a humanized monoclonal antibody that binds to CD20 antigen, which results in decreased IL-6 production. It has been used off-label for multicentric Castleman disease.

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