Untitled

Factors Associated With Complete Remission After Rituximab Therapy for Pemphigus

“…Reports on patients with RA and cancer have shown mixed results as to whether BMI affects rituximab efficacy. 19,20 Relevant clinical factors may include (1) suboptimal lymphoma dosing of rituximab in those with high BMI with use of the Dubois vs the Mosteller formula 21 ; (2) the nonlipophilic nature of rituximab, which causes poor penetration through fat tissue; (3) the obesity-associated increase in adipocytokines, which enhance inflammation and promote autoimmunity; and (4) impaired natural killer cell function in obesity, which may decrease rituximab efficacy via antibody-dependent cellular cytotoxicity. 22 In addition, prolonged corticosteroid therapy to control more refractory pemphigus vulgaris disease activity may have contributed to the association of high BMI with worse prognosis, although corticosteroids are unlikely to be the only cause of moderate to severe obesity in our study population.…”