I have had Rituxan brought up to me, if my IVIG doesn't work. My biggest concern is the JC virus which rarely causes an encephalopathy, which is fatal. All TNF blockers can cause this, and it is rare, on the other hand I have worked with wildlife and had Lyme, so I am kind of scared to take something that can activate organisms. Many of us carry the JC virus and it can be activated. If it is activated, and one develops progressive encephalopathy, it is over. That said, apparently Rituxan really works pretty well.