Rituximab and Covid : Hello everyone. I recently... - NRAS


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Rituximab and Covid

ks1966 profile image

Hello everyone.

I recently participated in a webinar about rheumatoid arthritis. I asked the Rheumatologist hosting the event about how does rituximab affect memory B cells and will my body produce antibodies in the case of a Covid infection. He said Rituximab depleted all B cells and “a Covid infection will render you as being unvaccinated and nullify any protection you had from any prior Covid infection”. To be honest this remark scared the S**t out of me.

Any thoughts or experiences please.

15 Replies

Although I've 'liked' your post, I'm not liking what you have learned! That's pretty rubbish tbh. I'd run that one past your rheumatologist.

ks1966 profile image
ks1966 in reply to Moomin8

Of course I will. His words where very sobering

He should have qualified his statement by explaining…. yes the infusion of Rituximab does initially deplete your B cells but they re-populate …however, they repopulate in different people over a different time scale.Over the six years I have been on Mabthera… the original Rtx, I have managed to graduate from four infusions a year to 2 but the longest I have managed to go between infusions is 7 1/2 months ….. whereas some people can go for over a year. But timing is difficult to decide.

I am only on the Mabthera…. I don’t have the methotrexate nor the steroids with it…as neither of them agree with me.

So all fingers crossed 🤞please that this old crone’s next infusion is back to its former efficient self!

Retuximab does deplete our B cells, but over time they do repopulate. We are not allowed the next cycle of two infusions until at least six months after the previous one. It would have been helpful if he had given more information about this and advised if possible the best time to have the vaccines, giving us a bit of hope.

AgedCrone profile image
AgedCrone in reply to sunnyweek

I have just seen my rheumatologist this afternoon …in the hopes of getting a date for my Rtx infusion in early July…he had a good old prod around….gave me the third degree….& said with my immune status….with or without antibodies ….it is his advice that I have the vaccination now….& the Rtx August/September…..that’s 8/10 weeks …he said having the vaccination too close before the infusion was not advised…but that was for me…you need to ask your rheumy nurse what time scale you should be on.My third primary jab was only seven weeks prior to my January infusion and that infusion did not work.

I pointed out that this timing mucks up my influenza vaccination date for the 22/23 winter…& and he replied all the patients in the local hospital with Covid….have autoimmune conditions & some are on ventilators….. so Monday morning I shall phone and say I will have the 4th vaccination I have been offered.I shall be furious if I get a bad reaction to the jab…. But over the 15 years he has been my rheumatologist has kept me on an even keel….so I think I would be irresponsible if I went against his advice now…. Although bottom line ….I’d rather just walk away from any more jabs.

sunnyweek profile image
sunnyweek in reply to AgedCrone

I hope the jab gives you no problems. 8/10 weeks prior to retuximab seems a long time I think, but yes best to be guided by your rheumatologist. He's obviously happy for you to have the vaccine four months after your last retuximab, did he check your b cells or your Ig's? That's my greatest concern, that b cells have repopulated.

ks1966 profile image
ks1966 in reply to sunnyweek

Hello. No they didn’t and I’ll bring it up when I see them soon.

AgedCrone profile image
AgedCrone in reply to sunnyweek

No ..I think you have misunderstood….I wanted my Rtx infusion 6 months after the last one….because that infusion hadn’t worked…but with Rtx the longer you can leave between infusion to vaccination the better…because the more B cells have time to repopulate…..so the better the chance of the vaccine working…too soon & it won’t work.Both my Rheumy & my haematologist have done their tests & both agree I should have the jab - dammit!

I wanted to skip the 4th vaccination…but rheumy said as it was now considered more important especially in the elderly to get any protection….especially as pre vaccination my Bcells repopulated quite fast….so I should have the jab…& then wait the 8/10 weeks & test again …& by then more research will be available…because prior to Covid there was no research on those immunosuppressed with RA on Rtx…as there were only the flu & pneumonia SARS type 2 vaccines.

I’m now fed up with the whole process.

ks1966 profile image
ks1966 in reply to AgedCrone

Thank you your reply. Are there any tests that can be done to determine my B cells have repopulated ?

AgedCrone profile image
AgedCrone in reply to ks1966

Yes….ask your rheumy nurse…but I don’t know if they do them on the nhs unless they are clinically necessary.

They’re still doing research into this. My partner is a statistician and he’s working with others in Scotland on this matter doing simulations because methods are giving different results. I don’t think any of them show vaccination is rendered null and void although effect might be much weaker.

AgedCrone profile image
AgedCrone in reply to cathie

If you read a lot of research on Cv vaccinations it does show that people with RA compromised immune systems on Rtx do react less positively to vaccination than those on otherDmards/Biologics.I guess that is why Rtx is the only named drug that is on these famous “lists”….without stating dosage.

ks1966 profile image
ks1966 in reply to cathie

Please share with us his findings when they become available. Thank you

They're trying to estimate just how much the Rtx limits the effects of the vaccination.

sunnyweek profile image
sunnyweek in reply to cathie

That will be very interesting information.

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