I have a question about treatment

[Mel]

Hi Everyone,
I wrote a few weeks ago about the possibility that I was having a flare. Well after blood tests and a bronchoscopy, it is confirmed that I am flaring again. I was in remission for a year and a half. I ended up in the hospital over Christmas, because my symptoms had worsened. I had IV steroids and they gave me an immediate boost. I am currently on 20 mg of prednisone (I was on 2.5 before) and back up to .8 ml of methotrexate. This is so upsetting to me because I was almost off all of my meds. My question is, I should be getting Rituxin in the next month, instead of cytoxan this time. Does anyone know if you can go back into remission without taking heavy duty drugs (for example only taking prednisone and methotrexate). I am not sure if this is possible or if anyone here experienced this. Please let me know! Thanks!

[JanW]

I don't know of anyone this has happened to, but remission can be induced with mtx (I'm not sure if you stepped down to mtx, or if that's the original drug you went on). So it seems that it would be logical that it could be re-induced with mtx.

[Mel]

I was not originally on mtx. I was brought into remission on cytoxan. My doctor used methotrexate as a step down drug. So I suppose it won't be enough this time around either. I am glad that I have the option of rituxin this time, but not happy about the flare up!

[elephant]

Hope the RTX gets you into remission. It is possible to get in remission and be drug free. You go girl!

[Jack]

The drug combination required will depend on the severity of the relapse. Mine were always caught early and I was able to recover simply by increasing the dosage of whatever I was taking at the time.

[Mel]

Jack, were yours caught when your ANCA was positive again? For the last while my ANCA was negative and now it is positive again and my blood inflamation markers were quite high. I think that is why I need rituxin. I need to ask my doctor about whether every time I flare (I hope there are not many more times) I will need to be on something so strong.

[Sangye]

Mel, the decision about which drug to use for a flare depends on the severity of the flare and the areas involved. This really isn't a decision for you to make, though. You need a Wegs specialist to do that. They might give you the choice between ctx and rtx, or between mtx and imuran, but they will give you their recommendations and the data to substantiate it.

[Jack]

I honestly can't remember the circumstances of my relapses now. It was over 20 years ago and I was much less well informed and involved with my own treatment. I was lucky to find myself being treated at one of the major research centres where they knew what they were doing.