RTUXAMAUD AND TYSOBRI

[DOCHART]

ANY PROS OR CONS THAT ANYBODY HAS    ?      I REALIZE EVERBODY IS DIFFERANT , BUT ANY EXPERENCES ?

[PeninaD]

Not sure that in USA methotrexate is mandated with rituximab for RA, and the studies she spoke of to us were US-FDA trials.  So there may actually be another reason, but as no further funds went into the US Rituxan trials, perhaps we will never really know the total reason? Sounds like following it up might give valuable clues.

[karryon55]

I think the incidence is so much higher in RA patients because of having to take Methotrexate with it. I was always on both Rituximab & Methotrexate injections up until I started getting Neutropenia & sepsis. In theory I'm not eligible for Rituximab unless I'm on Methotrexate at the same time which is protocol in RA (in Australia) & is how the clinical trials were actually carried out.

This is why it would be tremendously difficult for me to have to commence another DMD if this stopped working for my MS as I would always still need the Riuximab for my RA but using another DMD for MS would possibly cause  neutropenia again. This is too risky for me as my neutrophils (WBC) don't just lower they go to zero rapidly.

Karry.

[PeninaD]

Funny, just came home from bring my daughter for her Rituxan (rituximab) infusion.  The above is a very goods run-down of the situation.
Either Tysabri (Natulizamab) or Rituxan can only ever lead to PML if the person has the John Cunningham Virus. About 1/2 persons have it, but the incidence of PML is rare.  Our doctor was part of the testing of both drugs, and said that strangely, the incidence of PML is much higher in Rheumatoid Arthritis patients on Rituximab than on the MS population on Rituximab.  The incidence of PML was almost 0% in the MS group.

The same company that makes Rituxan has another monoclonal anti-body drug beginning testing, for MS.  Hopefully insurance will then cover that one.

[kwarendorf]

Hi DH - Welcome to our group.

I am currently getting Rituxan (rituxmab) and before this I was on Tysabri. They are the only two DMDs I've been on.

I have had good experience with both meds. Tysabri lasted about 20 infusions before it stopped working. The Rituxan seems to be doing the job now.  I started Rituxan in November of last year and finished my second round yesterday.

I had no adverse reaction of any kind to either med. The risk of developing PML, a rather nasty brain infection, is remote with both meds, but higher with Tysabri.

Other considerations include insurance coverage. The use uf Rituxaqn for the treatment is "off label". This means that even though it has been used successfuly for years, the manufacturer did not submit Rituxan for FDA approval specifically for MS treatment. This can make it diffcult to get insurance coverage, and it's not cheap. Tysabri is FDA approved for MS treatment and insurance coverage is typically easier to get.

Last but not least, or maybe least, Tysabri is administered every 4 weeks, with each infusion taking aboiut an hour. Rituxan is administered in two infusions, two weeks apart, with infusions taking as long as 6 hours. The 2 infusions are repeated every 6, 9 or 12 months,  My second course was 9 months after the first.

Kyle