How Does Rituxan Work?

According to rheumatology.org, Rituximab is used to treat rheumatoid arthritis (RA) that has not gotten better with other types of treatments. Rituxan is usually given as two intravenous infusions, the second one fifteen days after the first. This is usually repeated at six month intervals. Rituxan works by turning off a part of the immune system that is not working properly in autoimmune diseases such as RA.

As I understand it, Rituxan is not actually chemotherapy. It is a type of antibody therapy that can be used alone or with chemotherapy. Rituxan is a cancer medication that interferes with the growth and spread of cancer cells in the body. In addition to treating RA, Rituxan is used to treat non-Hodgkin's lymphoma or chronic lymphocytic leukemia. I read an article recently that mentioned Rituxan is also in the process of being approved to treat MS.

Rituximab targets a protein on B cells, which are part of our immune system. These B cells produce antibodies, which are proteins that allow the body to remove infectious or other dangerous particles. B cells also produce chemicals that help other parts of the immune system do their jobs.

People with RA make B cells that do not work the way they should. These abnormal B cells do not interact properly with other parts of the immune system. This autoimmune response attacks a person’s own body even if there is no infection. Autoimmune responses can result in a number of different symptoms, such as inflammation of the joints (arthritis), with symptoms of joint pain, swelling and stiffness. By temporarily removing the harmful B cells, Rituximab can help control the arthritis, and can help control inflammation.

Well, there you have it.  I think I get the basics of Rituxan after translating all of the million-dollar words and scientific terms. 

Fingers crossed that Rituxan will be a good biologic for me.

Here’s hoping for another good day!

Susan

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Ten Reasons Why Getting Less Sleep is Not So Bad...

As this week continues, my degree of sleep deprivation grows. I have decided to look at the positive side of “longer days, shorter nights” in order to reinforce that this situation is not always a bad thing.

Ten reasons why getting less sleep is not so bad.  Here we go.

Getting up early lets you…

1. Enjoy the cool temperatures of the early morning.

2. See the hummingbirds have breakfast at the feeder in the dark.

3. Drink the first coffee of the day, fresh from the pot.

4. Get work done before the household is awake.

5. Walk around the flower gardens and watch the bees.

Staying up late lets you…

6. Work on puzzles until you can’t write any longer.

7. Sit by the window and enjoy the nighttime breeze.

8. Snuggle up with kitty whenever you want to.

9. Take a lovely hot shower in the middle of the night.

10. Finish those long novels much more quickly.

There you have it!

Susan

Need More Sleep

Sure would be nice to sleep a full night’s sleep again.  I have been battling respiratory problems for four weeks now, and a good night of sleep is proving to be elusive if not impossible. Falling asleep at bedtime is not the problem. Staying asleep in the wee hours of the morning does not work for me.  I am able to sleep for 4 to 6 hours and then I wake up unable to breathe comfortably.   Talk about a hard “wake up call”, this would be the one.  Nothing like shortness of breath and rib pain to get you up and alert, whether you want to be or not. Add in the pain from an RA flare and you are ready to rock and roll, so to speak.

Yesterday was a high pollen day here in Colorado, and it definitely irritated my lungs throughout the day. The smoke from the many Western wildfires earlier in the month also got my undivided attention.  Guess I am one of those people they are warning when the TV or radio announcer says that the air is bad on a particular day and for people with respiratory problems to stay indoors or at least take it easy.  Wonderful.

I have been doing a lot of research on RA and sleep issues.  I have also been trying to find a way to overcome my inability to sleep at night, but to no avail. All of the recommendations for getting a good night of sleep tend to focus on falling asleep versus staying asleep until a reasonable hour. The meds I am taking may also be to blame, particularly the prednisone and the albuterol for dilating my lungs as needed.

One additional impact of my strange sleep schedule is that I am waking up my husband at these odd hours, too.  Even though he is able to go back to sleep, I know that my issues have an impact on his sleep, too. In the early days of this pleurisy thing when I was very ill, I would stay in bed and try to sit up and read or do a puzzle.  Bad idea when you are sharing your bed with another person as you are disturbing them.  Now I get up and leave the room versus trying to stay put.

This strange sleep schedule requires me to nap in the early afternoons just to get through the day.  I am certain that the nap is not the best idea, but it is the highest quality sleep I am getting right now. Not sure why it is easier to sleep a few hours in the daylight, but there you have it.

The good news is that I have gotten a lot of work done on my book revision in the wee hours of the morning, sitting here working in the kitchen with a cup of coffee. The cat likes me better, too, since he can come down for a snack in the wee hours of the morning and then head back to bed. The collie thinks I am great as he heads outside when it gets light and enjoys the cool summer morning.  Pet brownie points are pretty much my only reward.

I have also learned that the hummingbirds start feeding about an hour before the sun rises. Still hoping to see some interesting nocturnal wildlife (foxes, raccoons, porcupines, bears, bobcats), but so far no interesting animals have appeared around the house for my viewing enjoyment.

Any suggestions for extending a short night of sleep into something a bit more normal?  I would welcome them.

Here’s hoping for another good day!
Susan

Switching to Rituxan

Okay, let’s take a closer look at this Rituxan (Rituximab) infusion I will be receiving in the near future.  Genentech makes this particular biologic although it is jointly marketed by Genentech and Biogen. I initially used Enbrel and then Remicade, but my rheumatologist was unhappy with the results and is switching me to Rituxan as my third biologic.

Rituxan® (rituximab) is a chemo drug that is also used as a rheumatoid arthritis treatment.  It is used in adults with moderate to severe RA, and it is given along with methotrexate after another type of treatment, called an anti-TNF, hasn't worked well enough. I will be taking it with methotrexate, just as I did with the other biologics in the past.

I am still recovering from the pleurisy brought on in part (we think) by the Remicade.  That will take a few more weeks.  I deliberately scheduled my first two Rituxan infusions beginning 4 weeks from now to make sure this very slow healing process is complete.  Otherwise, it seems like a risk to mess with my immune system and have the pleurisy return with a vengeance.

Like all meds, Rituxan has some side effects.  Some of the side effects can occur during the infusion itself.  The side effects range from minor to quite serious.  At this point in my RA treatment, I think I am ready to try a new approach.  As I wait out the last of the Remicade in my system, I am becoming aware of just how bad my RA actually is.  Life in a permanent flare is not much fun and I would like to be able to be active once again.  It is easy to forget how bad you feel when a biologic is working some or all of the time to help you feel much better.

Looks like most folks get their Rituxan infusions every 6 months or so.  According to the website, Rituxan has been shown to provide up to 6 months of symptom improvement from 1 course of treatment (2 infusions, given 2 weeks apart). Sounds like a long day for this first infusion, stay tuned and I will let you know how it goes as we get towards the end of July.

If anyone is currently taking Rituxan or has done so in the past, I would welcome your comments and thoughts about this medication.  Many thanks!

Here’s hoping for another good day!

Susan