Imuran vs. Rituximab?

[LisaT]

Does anyone know whether rituximab has better results or is used more for WG than imuran? I am on prednisone and imuran and tapering the prednisone. However when I went from 10 mg to 5 mg I started noticing my airway feels narrower again (I have subglottjc stenosis), so I've started taking 10 again some days. I will run this by my rheumatologist next week, but he told me to taper by 5 mg a week, then quit from 5 mg to nothing without further taper, which seems very drastic but that's another issue. The more I read, the more it sounds as though rituximab may be the more appropriate drug for me given my subglottic stenosis (I would really like to continue breathing) and the possibility that the 'thing' in my chest (I'm calling her Petunia) is being investigated as possibly fibrosing mediastinitis, a rare condition about which I'm still learning but is apparently responding well to rituximab in trials... Since some of this is rare, weird, relatively new stuff, it is entirely possible that my rheumatologist simply doesn't know this. I am following up with someone I'm in contact with through the Canadian branch of the vasculitis foundation to consult with a Wegener's specialist here, but thought others on this forum could also be a good source regarding the two drugs and whether they have the same or different effects on WG symptoms. Thanks in advance for any info or insight you can provide. It is SO GREAT to have a place to come to with these questions!

[drz]

RTX is usually used for more serious cases and AZA (generic Imuran) is used more often for maintenance treatment after using RTX or CTX or for milder cases of Wegs that don't require RTX or CTX.

[LisaT]

RTX is usually used for more serious cases and AZA (generic Imuran) is used more often for maintenance treatment after using RTX or CTX or for milder cases of Wegs that don't require RTX or CTX.

Thank you, drz. I'm concerned that my Dr. may be assuming I have a milder case than I do or not realizing we should start with the stronger drug. I'm seeing him Tuesday to ask, and if he doesn't think it's a good idea I'll see my GP with a list of drs who know GPA and ask her to send me for a second opinion. It was a 'second opinion' appointment with a new ENT that got me on the right track in the first place. (After three or four appointments with the same ENT who, through many years of treatment, had few ideas and no treatment for me, and did not mention or refer me to the ENTs who specialize in vocal cord issues and subglottic stenosis and were able to help me.