I recently started Ruxience, a Rituxan bio-similar. It’s early, but I believe it is helping. Couple of notes for you: 1. My insurance company did not require pre-authorization for Ruxience. They declined Rituxan. Two rheumatologists and a transplant doc (they also use Rituxan) all said Ruxience is a great alternative. 2. Because Rituxan and Ruxience affect your ability to make antibodies, discuss which immunizations you may need prior to starting either med. Also see if your doc recommends Evusheld (prevents serious CoVid) for you. Best Wishes to you! Jo