How do you approach sequentially tapering combination therapy (i.e., IVIG, mycophenolate, rituximab) for dermatomyositis that is in remission?   

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...

Which medication to taper first for any immune-mediated disorder has to be individualized. As mentioned by Dr. @Tiniakou, 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 has h...