Rituxan | Arthritis Information

Tonight my RD suggested I add this to my MTX.

He said that although there are very serious side effects with this drug what people don't know is that they happen to the people who are using it as a chemo drug for cancer. That the cancer cells that are being killed off in large number are releasing something that mixes with the drug and causes these reactions. He says that for RA patients they are relatively non existent or very rare but when the FDA approved it's use for RA it would not let the drug company differentiate between the two.

Has anyone else heard that?

He also suggested Orencia and said it has less side effects than TNF blockers but when I read the pamphlet it sounded just as bad if not worse.....
My RD has said the same thing about Rituxan. All the premeds I get before the infusion are protocol-but due to the usage of it as a cancer drug.

Of course, every drug does have its risk of side effects and they are different for each person.I was a little surprised that he suggested it for me. I think of it as "Big Gun" medicine for those who are getting very little to no relief on MTX.
If I was to compare myself to what I know you are experiencing with RA - there is just no comparison.
How are you feeling by the way?
ok...thanks for asking. I got three injections yesterday for the sternum and I am due for Rituxan on Tuesday. RD is still wanting to send me to Duke for some answers. We'll see. I just don't want to add another DR. to my list...I know it must be a drag going from doctor to doctor but hopefully one of them will come up with a solution! Yikes injections in the sternum! Ouch! I would probably faint- I'm such a needle phob. I don't mind getting a blood test or a quick shot in the butt but I don't want to know about them anywhere else! Well... It might be a good idea to go with the Rituxan. My thought is that it is given every 6 months, so... less needles! Less needles is always a good thing for us that do not like needles!

Here is a needle story for you. I was over my mommy's today visiting and she got her new blood sugar monitor and I was setting it up for her and I decided I was going to try it on myself. My brother and niece where in the room. I was freaking out because I did not want to stick myself. My mom said I did not have to. I said I wanted to see what my blood sugar was. So... I sat there and was acting like a big baby, and my brother said just do it already! My mom looked at him and said "she is afraid of needles". My brother said "it is not a needle." I said "Do you know what a lancet is? It is a fancy name for a needle."

Then my husband said Just do already if you are going to do it. I said ok. Then I sat there contemplating it. then I had a bright idea... to see which of my finger tips was the most numb. Then I found it, it was my left pinky. I pressed the pen to my finger and said "its going to hurt! Its going to Hurt!" Then my niece came over to where I was and pressed the button on me and I screamed and then said "Oh wait... that did not hurt! I did not even feel it! Thank God for numb finger tips!" They all just laughed at me. It was not funny to me, but as long as they all got a good laugh out of it. LOL!
Well I know that the whole PML thing is really only risky when the patient is extremely immune compromised as in chemo patients. In fact I believe that the first RA patient that passed away from Rituxan complications had a previous history of cancer and was also on prednisone and mtx when doing Rituxan. All in all I would say the cancer and chemo thing was what caused it but I'm no doctor. PML sounds scary but guess what? It's also a risk with Remicade which I did not know. I was told this by the rd I saw in Cleveland and googled it when I got home...sure enough it's one of the risks of TNF inhibitors too. It just hasn't gotten the press the PML from Rituxan has for some reason.

As far as the whole "big guns" thing goes...I think Rituxan would be the big kid on the block with Orencia being his little brother. I would rather try Orencia first then move on to Rituxan if it fails which is what my doc and I are going to do. Actually I think she mentioned Orencia and if it fails then maybe trying Actemra as it should be out within three more months and she participated in clinical trials of it and had good results with the patients that actually got the drug. Something like an ACR 70 score or better for most of them so that one is promising.

Good luck

Bob
You might also want to check with your insurance company before making a decision. Before approving my Orencia, my insurance company made my doctor send in a letter, saying that I had already tried Methotrexate, Kineret, Humira, and Remicade. My insurance company would only approve it after I had tried some of the smaller guns.

The side effects that are listed on some of our medications are very scary. I went in to severe anaphylactic shock and almost died with my second infusion of Remicade. My RD told me "now you know the reason why they list all of these terrible side effects, some people can actually die, like you almost did". She also said that she had another patient have the same reaction I had, two days after me, while taking Rituxan. My intention is not to scare anyone, but just warn everyone to be careful and don't take the side effects listed, lightly. I learned the hard way and I have never been a cancer patient. It doesn't happen very often, but we all need to know that there is a chance that we could have a serious reaction to our medications. Please be very educated about the medication you are about to try. I hope you find a medication that works for you!

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