Using the agreed starting and stopping criteria, rituximab can be made available within NHS Wales for the second- or third-line treatment of fibrotic interstitial lung disease (not idiopathic pulmonary fibrosis) associated with connective tissue disease or idiopathic fibrotic non-specific interstitial pneumonia.

The rituximab product with the lowest acquisition cost should be chosen for newly initiated patients.

The risks and benefits of the off-label use of rituximab for this indication should be clearly stated and discussed with the patient to allow informed consent. 

In August 2019 OWMAG recommended this treatment in NHS Wales, in February 2024 there was a review of the recommendation. OWMAG found nothing new that effects the original decision.

Next review: this advice will be reviewed after two years or earlier if new evidence becomes available.