Hi. Can I ask the reason for doing IVIG as well as Rituximab? My medical knowledge is pretty limited, but is the reason to have better antibodies to fight of possible EBV once the B-cells grow back, and therefore hopefully prevent a relapse? Or do you take the IVIG to somehow increase the chances of response from the rituximab? And if so, how?
I am on IVIG only but may try Rituximab at some point if my doctor and I decide I might be a responder and the risks aren't too great.
Though I had multiple chronic infections, including Epstein Barr and low Immunoglobulins, which is a typical scenario for someone on IVIG for immunodeficiency, a major reason I am on IVIG is to try to attack/reverse my autoimmune issues.
My doctor has me on double the dose of patients with immunodeficiency. My side effects are more significant than those of immunodeficiency patients and all my doctors believe it's due to my autoimmunity and the fight it provokes in my immune system, in layman's terms.
At this point, after 9 months, my infections are better (which would be a prerequisite for Rituximab) and my autoimmune POTS has improved, though its far from gone. My doctor wants to increase the dose or frequency of the IVIG. I have tried backing off the frequency twice, but I got sicker until I got the IVIG, so I know its helping.
The reason for trying the IVIG would be to wipe out my B cells with any lingering EBV and the various autoimmune antibodies I've acquired, to clean house, so to speak. If I did it with an ongoing infection, I'd lose the antibodies to it and more would be produced, but the infection could be more dangerous.
Doing IVIG with Rituximab gives the body some protection while Rituximab has wiped out the B cells.
The risk to Rituximab is that you never make B cells again, but as the immunologist who told me that said, if you're already immunodeficiency and getting IVIG for the rest of your life, it wouldn't be any different...
This is my understanding now, but I will be discussing all very carefully with my doctor who has used both on other patients.
@Gingergrrl will likely give you a different view, but her situation is/was very different than mine, so you'll have to see what fits you.
Do you have any chronic infections?
The reason I'm asking is that I am a non-responder from rituximab, and I'm considering trying IMIG as a stand alone therapy. Just curious what your reasons are for taking them both at the same time ..
Happy to hear you have improved from the treatment!
All the best
Though its been an effort, I feel that IVIG has greatly helped me. Good luck!