Article from TheJournalofMusculoskeletalMedicine — Continued Promise for Rituximab...

**Palmyra** · 11-21-2012, 03:53 PM

Now that my daughter has been maintained on Rituxin for many series, if she is towards the end of effectiveness (meaning B cells are starting to repopulate, and it looks like she might be headed for a flare) her doc treats her with a short, high blast of pred (almost like a dose pack...40mg's for 4 days, then none...with no taper) and gets her in fairly quickly for another RTX infusion. She has gone for as long as 12 months between infusions.

I also think/hope you will feel better once off pred and the mtx. Best wishes LW

**ArlaMo** · 11-28-2012, 06:24 AM

It's exciting to see articles like this! I had a pretty lengthy discussion with Dr. Koening yesterday about the good things coming out about rtx - I look back at the 11 months I was on ctx with no improvement and wish I had been able to start with rtx instead. Interesting about the pred blast, Palmyra - I am currently on 80mg because of very severe scleritis and I'm dreading the taper.

**pberggren1** · 11-28-2012, 08:51 AM

We all wish we could have tried rtx in the beginning but at least now you have Dr. K.

**Palmyra** · 11-28-2012, 04:04 PM

I understand dreading the taper AriaMo...so sorry for you to be at such very high levels! I assume there is nothing topical that can help with that, or it would have been utilized.

And yes, that little blast of pred is something that has been effective for her at least twice in the past while on RTX. We'll see how long that lasts....
I am learning that there is a very fine line of walking with constant levels of immunosuppression (which RTX provides, albeit targeted to just B cells) and the risk of superinfection and the permanent damage that infection can occasionally cause. Too much immunosuppression vs too much disease. Walking a fine line indeed.

Best wishes to all...Jane