User Tag List

Likes Likes:  0
Page 3 of 3 FirstFirst 123
Results 21 to 25 of 25

Thread: Rituxan repeats

  1. #21
    Join Date
    Jul 2013
    Location
    Puyallup, WA
    Posts
    64
    Post Thanks / Like
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)

    Default

    If I am understanding correctly there are two different studies of RTX dose. One supports 2 doses and the other 4 doses. My cleveland doc(Villa-Forte) recommended 2 doses, and my rheumy here at home wanted 4 doses. I know one of the studies is the RAVE study, but can't remember the other study. Either way, the overall dose of Rituxan is about the same.

  2. #22
    Join Date
    Apr 2010
    Posts
    909
    Post Thanks / Like
    Mentioned
    14 Post(s)
    Tagged
    0 Thread(s)

    Default

    Hi mrtmeo,
    I haven't seen anything in the literature on the cumulative effects of Rituxan use either. I think a lot of the discussion between practitioners we are not privy to.

    Perhaps my doc is thinking of what Sangye said in the discussion in the link up above- "Dr Seo said that rtx seems to work better/ longer the more times you get it, but he also has said that it may stop working if you get too much"

    Not only do you get cumulative exposure to Rituxan but you get cumulative stress on the body (and mind) from Solumedrol. Continued hammering of the immune system is not really good. I don't completely understand the dangers of Rituxan use but I do understand the basics enough to know that we only want to use it just as much as is needed- and not more.

    I have seen the thinking on this evolve since it was first used and I see it continuing to evolve. Just as I saw an evolution in Cytoxan protocol. 36 years ago I was put on Cytoxan for two years. This is not common practice anymore.

    It is my understanding that the more Rituxan you use the more risk you have of serious infection. My doctor has expressed fear to me of using Rituxan more than just what is necessary and me getting a serious infection.

    As a last comment on the evolution of treatment. Currently , my six month "booster shot" of Rituxan is one dose. I do not have any sense that I would be doing better if I had more doses- this is just my hunch.

  3. #23
    Join Date
    Jul 2014
    Posts
    895
    Post Thanks / Like
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)

    Default

    Quote Originally Posted by me2 View Post
    Hi mrtmeo,
    I haven't seen anything in the literature on the cumulative effects of Rituxan use either. I think a lot of the discussion between practitioners we are not privy to.

    Perhaps my doc is thinking of what Sangye said in the discussion in the link up above- "Dr Seo said that rtx seems to work better/ longer the more times you get it, but he also has said that it may stop working if you get too much"

    Not only do you get cumulative exposure to Rituxan but you get cumulative stress on the body (and mind) from Solumedrol. Continued hammering of the immune system is not really good. I don't completely understand the dangers of Rituxan use but I do understand the basics enough to know that we only want to use it just as much as is needed- and not more.

    I have seen the thinking on this evolve since it was first used and I see it continuing to evolve. Just as I saw an evolution in Cytoxan protocol. 36 years ago I was put on Cytoxan for two years. This is not common practice anymore.

    It is my understanding that the more Rituxan you use the more risk you have of serious infection. My doctor has expressed fear to me of using Rituxan more than just what is necessary and me getting a serious infection.

    As a last comment on the evolution of treatment. Currently , my six month "booster shot" of Rituxan is one dose. I do not have any sense that I would be doing better if I had more doses- this is just my hunch.
    Hi me2,
    Good points.

    I agree with the one dose for maintenance if it works, but haven't heard any drs here doing that.
    I would assume that anything that we repeatedly take would cause the body to try to overcome it some how.
    Perhaps, this might be what can happen if too many repeated Rtx infusions are used?

    I know of people that had cancer repeadly and after a few chemo's the drs would say there is nothing more we can do.
    This makes me wonder if the same issue with cytoxic drugs reach a type of tolerance by the body's overcoming its effects, but not sure.

    I was reading some literature that mentioned with Weg's the T cells permanently activate causing the repeated flares and was wondering if anyone else knows more?

  4. #24
    Join Date
    Jul 2014
    Posts
    895
    Post Thanks / Like
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)

    Default

    I found this regarding our body creating antibodies to Rituximab.

    "The cases were treated with intravenous infusions of rituximab once a week 2 times (3 cases) or 4 times (6 cases). To prevent formation of antibodies to rituximab, mycophenolate mofetil (5 patients), azathioprine (1 patient), or a short course of Cyc (2 patients) were added or allowed to continue."

    Rituximab (Rituxan)

  5. #25
    Join Date
    Jul 2014
    Posts
    895
    Post Thanks / Like
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)

    Default

    Quote Originally Posted by morningsunshine View Post
    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,
    I asked my mom's nephrologist to do the test but he never responded to my email.
    I asked her rheumatologist and he said he doesn't know how to do the test but mayo does it and that I should ask her nephrologist to do it.

Page 3 of 3 FirstFirst 123

Bookmarks

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •