Rituxamab bio similar infusion.

[Backy]

Hi not been on for a fair time .I would like to ask if anyone has had problems with bio similar Rituxamab infusions. If so what. I am also having revised Knee replacement surgery next week.I am nervous but the pain and lack of mobility is the main reason for surgery.The Hospital and Surgeon are specialists in joint replacement surgery.

[Lolabridge]

Hi Backy

I’ve only had one cycle of Truxima (Rituximab biosimilar) about 16 weeks ago. There were no problems with either of the two infusions and the drug seems to be working well for me. I’m not aware of any side effects from the drug but I do have some minor ones from the Prednisolone I’m still taking at the moment.

I’ve not had to consider knee surgery since starting on Truxima. Hope yours goes well and I wish you a speedy recovery.

[AgedCrone in reply to Lolabridge]

Did you switch from Mabthera...the original Rtx Biologic, or go straight on to Truxima?

Reading between the lines it does seem if you start off on the Bio Similar things go well.

I have managed to stay on the original .......although now that price has come down my local HA ,seem less likely to push for change.

[Backy in reply to AgedCrone]

I started on original MTX in 2009.Switched to Truxima 2 yrs ago.I don't think it gives same level of control.Joints don't swell but painful.Rhemy appointment end Oct so will find out more then.Thankyou for answering.

[Lolabridge in reply to AgedCrone]

I started on Truxima having found Benepali did not work and had problems with all the tradiotional DMARDS. I've still got swollen and tender hands so hope that will improve with the next cycle ... If not perhaps I should ask to switch to the original!

[AgedCrone in reply to Lolabridge]

It doesn’t usually work like that as the similar is 99% identical to the original. If you are taken off a Biosimilar it’s usual to go onto a completely different Biologic drug.

Ask you rheumy nurse how your Consultant & HA view changing Drugs.

[Lolabridge in reply to AgedCrone]

Thank you for your advice - much appreciated.

[NeonkittyUK in reply to AgedCrone]

Sadly that one per cent of non identical seems to have given quite a few people I know a lot of issues when they have been on biosimilars. However they could have had problems on original products. Hard to call isn't it?!

[AgedCrone in reply to NeonkittyUK]

If you read the reports it seems if you start on the original Biologic then switch to a Biosimilar .....that can cause problems.

But if you start off having a Biosimilar things seem to go one of two ways......either it is a success, or it just doesn’t suit you.

So it really does seem you have to try it to see how you react to it.

No two people will react the same.....so presumably the doctors prescribing it just have to rely on their experience & their knowledge of the individual concerned.

[NeonkittyUK in reply to AgedCrone]

One would certainly hope so re the doctors prescribing to suit the indivdual! I have always been offered a choice and discussed with the rheumy and nurse so haven't actually been told to take anything, so lucky that way. I would have a biosimilar if I hadn't been on the original product and had to change if the current med failed . My team see no point in changing me to something which may not work as well when the current med works better than anything ever has.

If NICE/ law state in future that all rheumatoid patients have to try biosimilars first or if biosimilars are all that are available then .. that's a different scenario. I do read up on all the meds I have taken and may have thought about taking. Yes, those patients moved from original product to biosmilar do seem to have had problems from people I have known, and some on this forum. I had the pharmacist of the main hospital phone me, arguing with me twice and quite aggressively a couple of years ago to try make me swap but I refused. She said it is just exactly the same. My reply .. It wouldn't be called bioSIMILAR if it was! She said .. Do you know what a biologic is? My reply . . I should hope so as I have been taking one for four years! 😳 I explained why I didn't want to and my nurse told her to back off and so did the rheumy. So far she has.

[AgedCrone in reply to NeonkittyUK]

I was very lucky..the hospital rheumatology pharmacist listened to my reasons for wanting to stay on Mabthera & agreed straight away both on health & cost grounds.....that I should stay on it.

She now signs off my prescription for the Biologic nurses after my rheumatologist decides the dates I am to have it.

Not a happy bunny this time as it falls due on Christmas Eve.

[bpeal1 in reply to Lolabridge]

I started on Mabthera and had good results (although needed infusions every 6 months). Then 18 months ago I was switched to the biosimilar. I was more than happy about the switch as I am all for the NHS saving money. However, after the biosimilar I had a really rough time. I had loads of flares and generally my RA went out of control. I saw my rheumatologist to discuss what next. She said that although the biosimilar helps the same percentage of people there was quite a lot of anecdotal evidence that it wasn’t always the same people and she would like to try swapping back to Mabthera for the next infusion. Sure enough I had good control from the Mabthera so I have been allowed to continue on Mabthera and on my list of medication it specifically says rituximab Mathera brand to make sure I am always prescribed it.

[AgedCrone in reply to bpeal1]

When the letter was sent out in my area saying a Biosimilar was being introduced, it said if anyone had any concerns we should contact theRheumatology Pharmacist at the hospital.

I did this...had a chat & explained the various bad side effects I’d had over the years & said for the time I had been on Mabthera I hadn’t needed any extra meds & had only needed to see my rheumatologist for check ups. Prior to Mabthera I was seeing my rheumy at least every month.

She listened, & agreed it would probably be more cost effective for me to stay on Mabthera rather than end up having side effects with Truxima & costing the NHS to find another drug that suited me. It was a great relief to hear this.

Like you I do still need it every 6 months......I tried to go to every 9 months& literally after 6 months 3 weeksI had my first flare in 3 years. The next Mabthera infusion has worked.....but has not yet (4 months in) controlled the pain as well as before.I’m not in agony, but I’m not as comfortable as before. I see my rheumy next month so will see what he advises then.

[Troygirl]

There are two different kinds of biologicals. One is for TNF and the other is for iL-Proinflammatory Cytokines

The trick is finding which one you are?

Most RA Drs do not get deep down into genes & DNA!

Picking the right one for you is a merry go round!

[GranAmie]

had my 2 doses of Truxima [ritux biosimilar] for the second year in a row and am doing well ............. touch wood etc etc x

[GranAmie]

ps went straight onto TRUXIMA after recovering from MTX damage. nowadays take the odd paracetamol and just 2 tabs daily of sulfasalazine