crowneagle
12-16-2023, 08:40 AM
I just had a great meeting with my vasculitis doctor. Time has been running out for me for a long time. I barely made it to the third month after my latest RTX infusion. Three rounds of Solumedrol and a pred taper before and during my RTX infusion didn't help. My vasculitis doctor said my theory on infusion reactions making RTX work better was a valid concept. The premeds can actually work against RTX doing its job. RTX depends on two necessary responses, complement dependent cytotoxicity(CDC) and antibody dependent cellular cytotoxicity(ADCC). Premeds may suppress these responses from happening. Because 25%+- of people carry a genetic variant that might predispose them to serious infusion reactions, Genentech aired on the side of caution and put everyone in the same bucket, regardless of their chances of having a serious reaction. I asked my doctor if I could skip the premeds. He gave me an unforgettable look, first of shock and then of understanding, almost as if he's knew this question would come up, sooner or later.
Now that we were on the same page, he came up with a better idea. His former colleague and one of my former providers just did a study last year, trying Obinutuzumab, a second generation fully humanized anti-CD20 monoclonal antibody, on anca vasculitis patients. Unlike using mouse DNA, Obinutuzumab is fully humanized and stays in the body much longer, taking its time to seek out and destroy CD20+ B cells.
"Because obinutuzumab is considered to result in a more profound and longer-lasting depletion of total body B cell population, it is theoretically possible that use of this drug might provide better control of vasculitis than rituximab."
I'll let everyone know if and when I get approved for Obinutuzumab. I'm like a little kid, waiting to open my Christmas presents. Please read the study. I cannot be responsible for any misinterpretations. This drug may not be right for everyone. There may still be undiscovered side effects.
Obinutuzumab as treatment for ANCA-associated vasculitis
https://academic.oup.com/rheumatology/article/61/9/3814/6484636
Now that we were on the same page, he came up with a better idea. His former colleague and one of my former providers just did a study last year, trying Obinutuzumab, a second generation fully humanized anti-CD20 monoclonal antibody, on anca vasculitis patients. Unlike using mouse DNA, Obinutuzumab is fully humanized and stays in the body much longer, taking its time to seek out and destroy CD20+ B cells.
"Because obinutuzumab is considered to result in a more profound and longer-lasting depletion of total body B cell population, it is theoretically possible that use of this drug might provide better control of vasculitis than rituximab."
I'll let everyone know if and when I get approved for Obinutuzumab. I'm like a little kid, waiting to open my Christmas presents. Please read the study. I cannot be responsible for any misinterpretations. This drug may not be right for everyone. There may still be undiscovered side effects.
Obinutuzumab as treatment for ANCA-associated vasculitis
https://academic.oup.com/rheumatology/article/61/9/3814/6484636