Rituxan repeats

[mrtmeo]

You mom is so lucky to have you, mrtmeo. I always see you asking great questions here in the forums and it seems like you're very involved in helping her recover. Does she have WG or does she have MPA or is it still TBD?

Interesting about 2 doses of RTX...I've read 4 doses as the usual treatment in many studies. Maybe the two dose approach is specific to MPA?

The B-cell test I'm getting (about once every 2 months) is called T + B-Lymphocyte Differential and the results that my doctors always look at are:
Abs. CD 19+ Lymphs
% CD 19+ Lymphs

Perhaps she could ask for the T + B-Lymphocyte Differential test by name? It might be good info for you to have.

I'm keeping your mother in my thoughts! Fingers crossed that you find a treatment that works very soon.

Hi Morning,
My mom doesn't understand her disease at all and I try to explain everything including all the research I do and her blood tests.
She has MPA and had one 1.5gm infusion of cytoxan, skipped a week and 4 infusions 1 week apart of rtx, but didn't have a good response on the kidney and lung function.

Her Rheumy, that we just saw on Dec 3rd, said that the 4 infusions is the old way and consults with Carol Langford regularly.
The 2 infusions 2 weeks apart is what he said is the standard now.
I assume the heavy dosings may work faster, but not sure.
I have alot more questions now and should make another appointment with him.
I will ask her nephrologist to see if he will do the T + B-Lymphocyte Differential test and if he doesn't, I'll ask her rheumy.
Thanks for your thoughts!

[Eric54]

My rhum has me completing 4 ( once per week ) and then we discussed maintenance at 6 months. So far 3 complete. One more to go.


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[me2]

Well, I just spent some time surfing for information on Rituxan protocol. It seems there are conflicting answers to this question. I think one would have to ask their doctor about the rational for whatever protocol they are following.
Perhaps I am on two doses spaced two weeks because I have had so much previous exosure? I dunno. I can't find an article comparing and discussing the two protocols. I do know my doc has told me he is concerned about me being over exposed to Rituxan treatments and being suseptable to infection.

I found articles that described both protocols. Dosing & Administration | 6-Month Interval | Rituxan® (rituximab) RA

[Eric54]

The info you are referring to is for RA treatments. Click the gpa tab it states the following:

Rituxan should be administered each week for 4 weeks1
Following methylprednisolone infusions, oral prednisone 1 mg/kg/day is recommended (not to exceed 80 mg/day and tapered per clinical need)1


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[Eric54]

Either way I say leave it to your doc to help decide. It's good to be informed, but, sometimes this information isn't correct for our specific health reasons outside of this disease etc...


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[me2]

Yeah, you are right that the link is not for Wg, I picked it because of the protocol- and because I just did 14 hours of driving over the Cascade mountains pulling a trailer and was tired- LOL. Not my best shot at the subject.

There was a great discussion on this topic , on a Forum, in a Galaxy far , far away ...

With such luminaries as Sangye, Al, Aewaustin, Phil, Elena, Freaky, Chris G, Jaha, KathyB, Kami, DRZ, Meridith, Palmyra, and some doofus calls himself "me2" that keeps interrupting them.

http://www.wegeners-granulomatosis.c...-thoughts.html

[mrtmeo]

My rhum has me completing 4 ( once per week ) and then we discussed maintenance at 6 months. So far 3 complete. One more to go.


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Hope it is working well for you!

[mrtmeo]

Well, I just spent some time surfing for information on Rituxan protocol. It seems there are conflicting answers to this question. I think one would have to ask their doctor about the rational for whatever protocol they are following.
Perhaps I am on two doses spaced two weeks because I have had so much previous exosure? I dunno. I can't find an article comparing and discussing the two protocols. I do know my doc has told me he is concerned about me being over exposed to Rituxan treatments and being suseptable to infection.

I found articles that described both protocols. Dosing & Administration | 6-Month Interval | Rituxan® (rituximab) RA

Hi me2,
I haven't seen any data on accumulating doses of RTX anywhere in the literature.
Have you found anything about it?
Did u ask your Dr why he had a concern regarding it?

[MikeG-2012]

My rhum has me completing 4 ( once per week ) and then we discussed maintenance at 6 months. So far 3 complete. One more to go.

That is what my first doses were back in November of last year. I've had 2 2 weeks apart at 6 month intervals since then.

[mrtmeo]

Hi morning,
I'm thinking along the same lines as mrtmeo that 2 infusions is the current protocol for Rituxan. I'm surprised you are getting four. I'm assuming you get one per week for four weeks?
In the begginning they were doing four but as far as I know the current protocol is one infusion followed by one more
two weeks later.
I've done it both ways and I have to say I like doing only two if for no other reason I only get that horse dose of solumedrol two times.

Hi me2,
The horse dose of solumedrol is a really good point.
Only getting twice vs 4 times saves on the adrenals and muscle cramps.
However, when they gave my mom the 4 infusions, she got dexamethasone instead of salumedrol.
Not sure why.