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bdawg212
01-06-2015, 02:26 PM
Hey everybody, I just joined today, and I'm in need of some advice or input if you wouldn't mind.

I have had WG/GPA (whatever we're calling it today [emoji6]) since June of 2010 right before my 25th birthday. I was admitted into the ICU after a CBC showed renal failure. I was also in respiratory distress. I was tested for every disease under the sun, lupus, HIV, many cancers, etc. I didn't respond to an anti fungal, antibiotic, or anything else until they put prednisone into my IV. Obviously, that made me bounce back within 24 hours, but they still couldn't figure it out. My ANKA tests were repeatedly negative. I was released, then ended up back in the ER five days later with a severe colon bleed. My HGB was down to a 6.0. I received blood transfusions and a colonoscopy with biopsy. The biopsy showed nothing. A kidney biopsy that was sent to Mayo Clinic showed nothing. There were granulomas in my lungs that left after pred treatment. They were unable to biopsy any of these granulomas because my airway was so inflamed it was compared to a "crushed straw". Again, the prednisone helped and I left the hospital without a diagnosis. 2011, I had another milder flare. Repeat with 2012. In 2013, I had a severe flare that saw my sed rate at 99 and my CRP at 11.0. Finally, I found a doctor who was willing to take me on. At first he thought I had polyarteritis nodosa because I have had no lung or renal involvement since 2010, but recently my doctor has arrived at GPA instead. Injectable methotrexate has had no effect. I had four Rituxan infusions two weeks apart. The first was on Halloween. My blood tests from Friday just came back today and my CRP and sed rate are at 4.7 and 76 respectively, WORSE than they were pre-infusion. Therefore, the Rituxan, the super expensive supposed-to-be miracle, has done nothing. As of today, I'm back on 40mg of pred and starting Cellcept. It's funny, because I feel okay, except for bowel involvement. I have had a lot of bowel involvement, which I guess is rare in GPA, but can happen. I also have joint pain and sinus ulceration. However, I go to work every day as a translator, and I'm able to keep up with cooking and laundry and housework and family and friends. My doctor tells me that inflammation that constantly high should keep me on my ass, but it just doesn't.

I'm scared to death that nothing will work. Just looking for support and hopefully I can help some others along the way.

Pete
01-06-2015, 02:35 PM
Rituximab generally takes 4-6 weeks for definite results. If my math is right, you had your last infusion around Christmas. You should be seeing improvement soon. Good luck!

bdawg212
01-06-2015, 02:36 PM
Thanks Pete. I hope you're right. Since my first infusion was two months ago, my doctor was expecting some improvement by now. The fact that the inflammation went UP instead of DOWN is very discouraging. $100,000 of medication down the drain...

pwc51
01-06-2015, 09:19 PM
Although mine has worked quite quickly in the past I was advised by my consultant that it can take anything up to 6 months to be effective! Seems like a long time to me but am passing it on as information I was given.

amy.r.kahl
01-08-2015, 07:13 AM
I agree with dirty don I was told when I first started taking it that its full effect may not be seen until 6 months also I believe that since its a new drug doctors are being very conservative with the dosage amounts. I'm on it but feel my dosage needs to be increased to keep my sinuses in check it has helped my lungs. But my doctor is all over the place so I'm going to see a specialist in WG if you haven't found a doctor that's a specialist do so now because it can only help you. I think everyone on here will agree. Your flare up systems are very scary so do not be a lab rat for a non specialist. I'm not dissing your doctor I'm sure you trust him.a
A specialist is best for a specialized disease.


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bdawg212
01-08-2015, 07:15 AM
I saw a WG specialist at the University of Wisconsin Hospital, one of the best in the Midwest, and he didn't want anything to do with me. He didn't even call me back. When I went back to see him again, he pretended he didn't know me. :-/

amy.r.kahl
01-08-2015, 07:21 AM
Bdawg212 don't let one persons ignorance be yours. You have to be able to trust your doctor. Find another one!! I know it's hard being sick and dealing with doctors nonstop but you have to know your self worth, and never let another person downgrade you.


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bdawg212
01-08-2015, 07:23 AM
My doc now is a rheumy and I love him. I'm just saying, I tried to talk to a WG specialist and he wasn't interested in my case.

amy.r.kahl
01-08-2015, 07:24 AM
Really what doctor was it? Is your blood test positive or negative?


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bdawg212
01-08-2015, 07:26 AM
I don't even remember his name. It was in 2010. I have always been ANKA neg. The rheumy/immunologist I have now is the only one I have found that really cares about me and my case because I am not a typical Wegeners patient.

amy.r.kahl
01-08-2015, 07:37 AM
Bdawg212 I remember every doctor that I have seen....and fired. Just BC one specialist was rude doesn't mean all are rude. And that guy has some of the most scary symptoms I've heard of I mean come on ur air way being referred to as a crush straw!! I think he should try a specialist if you think a specialist is bad then you should post your experience not post that specialist aren't great.


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bdawg212
01-08-2015, 07:38 AM
Yeah, I didn't say specialists aren't great. I just said I tried one and I love my current doctor. I was mostly wondering if anyone had problems with failed Rituxan. Thank you anyway.

im so blessed
01-08-2015, 07:55 AM
Im sorry ur going thru all this....it is a very difficult disease to find the right fix for each individual...im glad u are comfy with ur dr. That is important! Ive never done rituxan but am considering it since my current mix of imuran and methotrexate are not keeping my stenosis quiet. I think rtx has helped many but i hear it takes time and like every other side if this disease, each person will respond differently. Best to you :)

bdawg212
01-08-2015, 08:05 AM
Thank you blessed, I appreciate the support. Methotrexate didn't work for me either, so I can feel your pain there. I hope the Rituxan works for you and you get your stenosis under control. Take care to you!!! [emoji170]

mrtmeo
01-08-2015, 09:21 AM
My mom didn't have the great response most have with rtx.
She is in her 6th month from first infusion and has not gone into remission.
The first couple months caused her symptoms to flare worse than they ever did.
Now, she is on Mofetil to see if she goes into remission and is helping except she gets sick on the higher dose.

I think with Rtx, it works best if someone has been in remission before or they caught the disease early.
It does work much slower, but the b cells start regenerating starting around the 6th month.

Did they ever do a kidney biopsy when u had the kidney failure?

MikeG-2012
01-14-2015, 11:22 AM
I saw a WG specialist at the University of Wisconsin Hospital, one of the best in the Midwest, and he didn't want anything to do with me. He didn't even call me back. When I went back to see him again, he pretended he didn't know me. :-/

If you are anywhere near Monroe, WI, let me know. I can put you in touch with my team of Docs at the Monroe Clinic.

mrtmeo
01-24-2015, 03:15 PM
Hi BD,
Have you had any improvement with the cellcept?

Rose
01-25-2015, 06:39 AM
Hi and welcome.

Just like to say that I have bowel involvement and of all the organs that WG has attacked (sinus, lungs, kidneys etc) the bowel involvement has given me my worst symptoms. it is rare and I went undiagnosed for17 years despite numerous scopes test etc. A few years after it attacked my other organs in 2007 (when the WG was diagnosed) I had a rectal bleed and had another colonoscopy. This time they looked for WG in the bowel and the initial histology test showed nothing but a further test was done which showed active vasculitis in the small blood vessels. ( although mild at the time blood test said I was in remission)

i hope you start to respond to the RTX soon. My remission was induced with cyclophosphamide and is being maintained with Cellcept....6 years almost now.

Rose

mrtmeo
01-25-2015, 07:16 AM
Hi and welcome.

Just like to say that I have bowel involvement and of all the organs that WG has attacked (sinus, lungs, kidneys etc) the bowel involvement has given me my worst symptoms. it is rare and I went undiagnosed for17 years despite numerous scopes test etc. A few years after it attacked my other organs in 2007 (when the WG was diagnosed) I had a rectal bleed and had another colonoscopy. This time they looked for WG in the bowel and the initial histology test showed nothing but a further test was done which showed active vasculitis in the small blood vessels. ( although mild at the time blood test said I was in remission)

i hope you start to respond to the RTX soon. My remission was induced with cyclophosphamide and is being maintained with Cellcept....6 years almost now.

Rose

Hi Rose,
Was that test for the GI vasculitis an abdominal angiogram?