Rituximab Round Two

[Sangye]

Jan-- you are right on about asking docs questions. We have to be informed and know what we're taking and why.

Snooz-- Rtx has been safely used for Non-Hodgkin's Lymphoma for at least 10 yrs. Many more rounds than we would get. But it's true that they don't know the long-term implications for rtx and Wegs. My doc is also hesitant to use it more frequently on younger people for that reason. I'm 46 and he considers me young enough to use it as sparingly as we can.

Using ctx in a young person comes with its big problems, too. It's the "devil you know vs the devil you don't" scenario. Personally I have a better feeling about rtx than ctx. That's entirely a personal gut feeling thing, though.

[JanW]

I'm with Sangye on the gut feeling about rtx vs. ctx because of the toxicity (although obviously I would take it if that was the only thing that would help me). As for rtx vs. mtx -- I think if mtx works for you, it's got an excellent profile in terms of safety and long term use at least as far as RA patients go. My rheumo indicated to me that he might try it on me again even though my liver numbers weren't great -- it might just mean that I couldn't drink at all or take ibuprofen while on this medication. He likes it because of its ease of dosing and safety profile. He likes rtx too -- his hospital was one of the test centers -- but I think the combination of the fact that its an infusion and the insurance company hassles makes him at least try out the easier thing first.

[Sangye]

BIG price difference between mtx and rtx. Mtx is super cheap.

As far as I can tell, it doesn't appear that they choose between Mtx and Rtx too often. Mtx is used with milder disease or to maintain remission. Rtx is used for severe disease or to induce remission.

[JanW]

I think you're right Sangye -- more likely a choice between cytx and rtx. I know that my insurance company doesn't require alternate therapy "failure" (but does require a precertification and a letter from your doc), but many still do, and most likely the drug you would have failed on would by cytx, because its the most commonly used drug for aggressive disease.

And yeah, I figured mtx was wickedly cheap when it was in the lowest level of my prescription plan's formulary (I think it's $7 a prescription).

[Sangye]

I'm off for the first rtx infusion today. I'm a bit scared about how weak I got the last time. I tried to do a bunch of stuff the last few days in anticipation of being wiped out again. I hope it doesn't happen, but I'm prepared if it does.

[elephant]

Good luck Sangye, this is a good thing for you. I am crossing my toes for you that you don't feel weak, but stronger in the next few days. I will be thinking about you.

[JanW]

Good luck, Sangye. Stay strong!

[Jack]

We are all thinking of you Sangye!

[Lightwarrior]

Sending you light and energy. I'm glad your prepared

[Sangye]

Thank you everybody-- it's so nice to come home to messages like this.

Just got home... Went exactly like the ones in October. Turned totally pale within an hour, legs are like spaghetti. The pharmacy was delayed in sending the rtx to the clinic, so I had 100mg IV solumedrol and 25mg Benedryl on board for at least an hour before the rtx was started. I have a feeling much of this reaction is from the pred. As soon as it went in the IV I could feel it. Hard to describe the feeling--kind of like a massive hit of caffeine. Within 30 minutes my jaw was clenching involuntarily and I was shuddering. All this before the rtx.

I tell you, pred just doesn't live in my body well at all.

The woman next to me was getting an infusion for scleroderma. I'd seen her in October and she's world's better. She didn't mind being on pred. It obviously hadn't changed her body at all-- she was slim, no double chin, etc.... We're all so different.

I sure hope it doesn't continue this way for the next 3 weeks. I was in pretty bad shaped going in and was so much worse coming out! I told the friend who drove me that I felt like I got a reverse blood transfusion.