Do you prefer to taper rituximab by extending the interval between doses or decreasing the actual dose administered for RA patients who have achieved longstanding remission?

My practice has generally been to extend the interval, albeit with careful observation of the patient's clinical status throughout the process. To begin with, my practice is to start with 2 doses of 1000 mg at initiation of therapy, and then a single dose of 1000 mg for subsequent courses of therapy...

I completely agree with Dr. @Dr. First Last about the durability of rituximab responses. It is as if each patient has their own 'rituxometer' about the length of response before requiring retreatment. This was observed in the early studies of rituximab. As stated by Dr. Ruderman, this 'rituxometer' ...

Just to add to the dialogue- many in the Vasculitis space believe that patients often imprint the interval for remission as well - so some people do not need q 6 or even 12-month infusions.