How do you approach sequentially tapering combination therapy (i.e., IVIG, mycophenolate, rituximab) for dermatomyositis that is in remission?
Would you taper the IVIG first or the cellcept/rituximab?
2 Answers
Mednet MemberInvited Expert
Rheumatology · The University of Texas Health Science Center at Houston (UTHealth)
Answered on
This process involves trial and error and requires collaboration between the physician and the patient to determine the most appropriate tapering strategy. My personal preference is to begin tapering medications with the highest risk of side effects. Among IVIG, mycophenolate, and rituximab, I would...
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Neurology · Cedars-Sinai Medical Center
Answered on
Which medication to taper first for any immune-mediated disorder has to be individualized. As mentioned by Dr. @Dr. First Last, the relative risks are an important consideration. But, so is which medicine is most likely to have had the greatest effect. Rituximab is frequently given after the patient...
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