###Human: Post chemotherapy, there is remission of RA with pain in joints. Please help. ###Assistant: Hello. I have gone through your reports (attachment removed to protect patient identity). It seems her arthritis is flaring up again. Eventually, Cyclosporine and HCQs are both very mild when it comes to arthritis management. She may have had a prolonged suppression due to Rituxan injection. At this stage, my suggestion would be to restart Leflunomide. As the TLC (total leukocyte count) count is still low, Methotrexate may not be the best choice. Secondly, she can take injection Kenacort 80 mg (Triamcinolone) intramuscular once a week for two weeks. It will settle the inflammation fast. Thirdly, use minimum pain killers. As they are not a wise option when aplastic anemia is in the background. I hope this helps.