What is the difference between Methotrexate and Rutiximab?

[sarahdollygirl]

I have CSS and my consultant here in France took me off methotrexate at the beginning of last summer which resulted in the disease re-emerging with a vengance! I have been having Rituximab infusions since November (initially 2, 2 weeks apart, then 6 monthly). What is the difference between Methotrexate and Rutiximab? I will add that I was beginning to suffer side effects from the methotrexate after taking it for 5 yrs, mostly digestive and stomach probs. Thanks

[PMRpro]

Methotrexate is what is called a DMARD - Disease Modifying Anti-Rheumatic Drug. It is cytotoxic which means it is a medicine that contains chemicals which are toxic to cells, preventing their replication or growth, and so are used in high doses to treat cancer. They can also be used in very much lower doses to treat a number of other disorders such as rheumatoid arthritis and multiple sclerosis and some forms of vasculitis. It suppresses the immune system.

Rituximab is an intravenous drug that is used to treat rheumatoid arthritis and B-cell non-Hodgkin's lymphoma amongst other things. It belongs to a class of drugs called monoclonal antibodies. Cells have receptors on their surface and antibodies can attach to them and change how the cells work. The effectiveness of rituximab is a result of it temporarily depleting the number of B-cells, cells of the immune system that are important in promoting inflammation in various diseases.

Does that help?

[sarahdollygirl in reply to PMRpro]

golly - thank you. Am I right in thinking that Rutiximab is less toxic than Methotrexate?

[Hidden in reply to sarahdollygirl]

As I have bothe MTX and Rituximab, I would say yes. Others may feel differently.

[PMRpro in reply to sarahdollygirl]

Um - differently toxic maybe! Some people take methotrexate in rheumatoid disease doses and never have any problems at all, others (about a third) find it too bad to continue with. I suspect the same may well apply to the biologics (monoclonal antibodies are also known as biologic drugs). Everyone is so very different in how they respond to different drugs.