Rituxan works by eliminating autoimmune B cells. It has been useful in RA (FDA approved) but also in other autoimmune diseases such as lupus, immune mediated thrombocytopenia, Wegener’s vasculitis. On a theoretical and in real life, Rituxan works the best when there are autoantibodies. For instance, in RA, patients who are RF or anti-CCP positive seem to respond better. Since in PMR, most patients do not have measurable autoantibodies, it seems unlikely that Rituxan will have much benefit.
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