Reply To: help getting BCBS approvial for Rituxan treatment of CIDP

It was not long ago that ivig was off label for cidp, actually when we started it was. Anyway, if your doc is diligent and writes to bcbs, they usually eventually approve. He would have to include your adverse reactions to ivig as documentation as to why you need the rituxin. As well, if there is documentation to show progress while on the rituxin have him include that. I am sure you know all of those things already. If all else fails, maybe your doc would consider sub Q ivig. Search the archives for a member named Julie. She had awful experiences w/ivig and switched to sub q. As well, a member named Starli had good results. Are you able to see immediate results with the rituxin? Typically when people start on it they have to be on it for a while before it works. If that is so for you too, maybe if they do approve it, you can ask to switch brands of ivig. We did not do well at all on nu factor or this other one that is no longer on the market. Gammunex was a little better, but gammaguard seems to work best for us. Granted we still get the aseptic reaction the next day and throw up w/flu like symptoms, but the worst is over in a day compared to a week with other brands.

Another consideration could be to use solumedrol (steroid) in conjunction with the ivig. There was a member named Gabrielle I think that would also get very sick w/ivig but when solumedrol was added she was able to tolerate it.

Good luck to you, we will say a prayer for you.