Rituximab or Remicade for Rheumatoid Arthritis RA

The Market name for Rituximab is Rituxan. It is also prescribed for blood cancers, and may not be the front line for RA. However, Remicade, is one of the few medications that allows infusion every 8 weeks, which may be a convenient schedule.

Rituximab can cause a range of side effects, from mild infusion reactions to serious infections and rare brain complications, requiring careful monitoring.
Common Side Effects
During or shortly after infusion, patients may experience fever, chills, shaking, fatigue, headache, cough, nausea, muscle or joint pain, flushing, fast heartbeat, shortness of breath, or tongue swelling. These reactions are often managed by premedication with corticosteroids, antihistamines, and paracetamol and by adjusting the infusion rate. Some patients may also develop stomach or bowel discomfort, diarrhea, or mild skin rashes.
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@altabiznet I just started today taking rinvoq to replace a methotrex I've been using for the last 20 years which is work great except for the last 2 years I've had too many flares so we're switching to rinvoq and I'm very excited. Because I've had so much hair loss I also have hypothyroidism and secondary sjogren's disease so it's not actually for hair loss but it can help hair loss which I've had a lot with. Anyone else taking rinvoq?

I’ve done both. Rituxan I had the two loading doses and then the follow up dose, but I subsequently developed a bad case of Covid so my doctor took me off Rituxan, and I was still on a fairly high dose of Medrol and hadn’t had a chance to taper, so I never got a chance to find out if it worked or not. It is a B cell depleting therapy and I tolerated it well without any severe side effects other than being a bit tired on infusion day.

I trialed 6 other biologic drugs without success after that and Remicade was going to be a last resort for me last summer as the dose can be increased and if you need more suppression, your doctor has the option to shorten the time between infusions so instead of every eight, you can get them every six or even every 4 weeks so there’s a lot of flexibility. Unfortunately for me, after the second loading dose I developed ataxia so they stopped as there was a concern that I might be at risk of MS. It can happen in a very, very tiny percentage of people, but I already had tremors and hyper reflexia so I already have some CNS issues so the decision was made to stop the Remicade just in case. But it didn’t cause any GI issues or cause any headaches or anything. My doctor said for many it works very well because it is one of the very few drugs that gives a doctor the ability the tweak the dose and change the intervals to fine tune the amount of suppression a patient needs. I hope it works for you 😊

I have been on Remicade for the past 10 months. Started lower dose, but had to increase after 2 infusions as it was negligible in my system, so up to 10mg. Have done that for 3 infusions, getting set for 4th.
I have not had any side effects (knock on wood), and so far, so good; the inflammation is reducing a bit.

@pm56

Thank you for sharing. Rituximab in addition to RA is now considered for other autoimmune conditions, like scleroderma. This may be my next treatment, as I have arthritis related to scleroderma. Hoping that it may work for me.

Remicade sounds like a much stronger medication with potential for neurotoxicity. May need to be careful with it. Thanks again for your insights.

@phxjana

Thank you for sharing this valuable experience. If Remicade is prescribed to me, I would now consider starting with lower doses. Same for Rituxan - to be on the safe side.

@synthiame

I did not have Rinvoq. Please keep posting your experience with Rinvoq, e.g. how quickly you may get a response, potential toxicities, how it was managed, etc. Thank you for responding.

Just be aware that with Rituxan you should take more precautions to avoid being around others who may be sick and to avoid crowded places during flu season unnecessarily. For example, I always tried to avoid going to the ER during the winter so I didn't have to sit elbow to elbow with a waiting room full of sick people if I could put a call in to my doctor to see if it was something we could deal with via telehealth; if I couldn't avoid it, I masked up as Rituxan does make you more immunocompromised. But that was something I would have gladly traded if it worked! Truly hope it works for you!

My daughter has 5 auto immune diseases and she is still searching for the right drug for herself. She is on long term use of steroids, and they need to get her down to a low dose as it is destroying other parts of her. She took Remicade. She had a terrible allergic reaction while they were infusing. She started bleeding and unfortunately the doctor persisted that they finish the dose. It was really, really bad. But, she hasn't tolerated any of the newer drugs, but Humira worked well for her for years. It's well tolerated, and it's one of the oldest of. its class, so more time and research. If. that's a choice, I recommend asking your doctor. I think insurance covers it. For her, it stopped working, but it worked for a long time.. and she is really bad. Good luck. I am only on here because she won't and I am searching for her too. With 5, you can imagine Lupus, Crohns RA, Bechets, shorgrans.