I’ve actually been on both. Rituxan didn’t do anything for me, and from what I remember you usually have to wait about 6 months before switching to another biologic.
I was on Remicade for almost 15 years. Over time I ended up developing polymyositis and had to start IVIG, which is what led me to Mayo Clinic. While I was there, they told me I likely never had ankylosing spondylitis in the first place (which is why I was originally put on a biologic). They also said my polymyositis was probably medication-induced, which I had barely ever heard of happening.
Since they didn’t really give me a new treatment plan, I went through my labs and chart notes (I used to work in the medical field) and saw that I had developed antibodies to Remicade. From my understanding, that basically means the medication isn’t effective anymore because your body is neutralizing it. After discussing everything and not having a clear plan forward, I made the decision to stop infliximab.
After stopping it, I actually went into remission for about 2 years. Then I went through a couple of major life stressors, and everything came back hard—it felt just like the polymyositis all over again.
I found a new rheumatologist who wanted to start completely from scratch. After repeating all the testing, I was just diagnosed with an overlap syndrome involving polymyositis. We were hoping stopping the drug might have reversed things, but that didn’t happen.
On top of that, I was also diagnosed with probable medication-induced lupus (likely from Remicade), and psoriatic arthritis—which didn’t surprise me since I’ve had psoriasis for years.
I know my situation is pretty rare, and most people don’t have this kind of experience with Remicade. I’m just sharing so you’re aware of what can happen, even if it’s uncommon.
Definitely make sure you understand the risks and side effects before starting, and talk everything through with your provider. Wishing you all the best!