Hi Mccourtjs, Keep in mind that I am not a doctor. I do not know your medical issues or how long you have tried any medication. I do know that for many people, It is important with the DMARDs to start at a lower dosage and gradually move to a higher dosage as you adjust to the medication. I know for myself that If I begin some of these DMARDs at a high dose then I would have a toleration issue. Consider how long you have taken a particular med. If the med was taken only a short time, then you might NOT actually have a toleration issue, it might be that you started at too high a dose and did not adjust. I started my Cellcept at too high a dose and I had a big blood pressure drop. I stopped all meds for a couple of months except for my Prednisone. I later went back and tried Cellcept again only at 500mg. I moved up the dosage as I adjusted. Today, I do well at 750mg of Cellcept. My DM is well under control even though it is active disease.

Cellcept kills B cells. Rituxan is also a B cell killer at a much higher dose.

I have a fatty liver and DM with overlapping Scleroderma. I also have Chronic Kidney Disease. I would not qualify for a Rituxan infusion. You can read Rituxan side effects on Drugs.com too.

Rituxan is a medication when you have been on other DMARDs for a reasonable to "long" period of time and the disease is at a point where the other meds no longer work. Rituxan is also a beneficial med for some cancers too.

I also have active disease. I take 5mg of Prednisone and 750mg of Cellcept. My active disease is well managed at this point. There will probably come a time when my medication dosages will need to go higher too.

Do visit The Myositis Association website at www.myositis.org for additional opinions and research literature on infusions too.

Consider your situation carefully. It never hurts to get a second opinion about your bloodwork, and current medication dosages. I would definitely consider a second opinion or talking to other doctors to see if an infusion would be a consideration. If you are really ready for infusion, then other medical professionals would be in agreement too.

I know that there are many people who will be able to share their infusion experiences. Best wishes on your decisions too.

Thanks trpt1. My rheumy decided that I should try the cellcept again at 500 mg once a day. When we stopped the cellcept I was taking 2000mg and I can't remember if we built up to that dose or started there. The new dose will be in addition to my MTX, 25 mg and prednisone, 8 mg. I have tapered the prednisone over he past month 1 mg every 2 weeks and he wants me to continue the taper to 4 mg unless I have issues. I have not been able to get below 8 mg in other taper attempts so we will see. I too have a fatty liver. A few weeks ago we tried tachlimus but it made me sick and I know it ws effecting my liver so we stopped. Cellcept is the latest drug and he mentioned acthar as our next drug if this doesn't work. I can't wait until we find the correct mix. I have been reading a lot about the rituxin but wanted to also hear personal experiences in case that is in my future.

I was given Rituxan for cancer treatment. During my Rituxan treatment, I got PM.

My understanding is from a cancer perspective. It is a bio-therapy like chemotherapy. I was told it doesn't kill cells but it attaches to B cells and forces your body to attack those cells. While I was on Rituxan, I had fatigue and headaches.

I would work with your doctor on which is right for you. It really depends on your symptoms and your general health.

I got infused with Rituxin in November and December and haven't had to go back since. I feel pretty good. My doctor told me that I could go up to a year between treatments. That is lots better than the 6 weeks between IVIG treatments before the rituxin.