Low-dose rituximab is effective in pemphigus

Abstract

A low dose of rituximab is an effective and safe treatment for pemphigus. Relapses may occur, mostly at the end of the second year. Cost-effectiveness studies with a long follow-up are required to determine the proper dosage of this expensive drug in pemphigus.

Pemphigus. S2 Guideline for diagnosis and treatment – guided by the European Dermatology Forum (EDF) in cooperation with the European Academy of Dermatology and Venereology (EADV)

“…38 Lower doses of rituximab are less effective 39,40 • Rituximab can be combined with short-term (<4 months old) systemic corticosteroids and long-term (>12 months old) immunosuppressive treatment…”

To Compare the Cost of Rituximab and DCP Therapy in Pemphigus in a Government Tertiary Hospital

“…A recent prospective open case series reported that a low dose rituximab regimen consisting of two 500 mg infusions separated by two weeks was effective in pemphigus. This is just 39% of the hematological dose and yet more than 73% of the patients achieved complete remission [6].…”

“…Both lymphoma regimen (four, weekly infusions of 375 mg/m 2 ) and rheumatologic dose (two infusions of one gram each separated by two weeks) have been successfully used to treat autoimmune blistering diseases including pemphigus [5]. Studies have shown that antibody producing B cells in the Pemphigus are not malignant and a single dose as low as 100 mg/m 2 can deplete B cells [6]. A recent prospective open case series reported that a low dose rituximab regimen consisting of two 500 mg infusions separated by two weeks was effective in pemphigus.…”

“…In Rituximab group follow up period is 2 years unlike the DCP group where it is about ten years [6][7][8][9][10][11].…”

Dermatolojide Rituksimab Kullanımı

“…Düşük doz rituksimabın da etkili ve güvenli olabileceğini düşünmüşlerdir. Bu tedavi yönteminde relapsların özellikle tedavi sonrası 2. yıl sonunda gözlendiğini belirtmişlerdir (88). Matsukura ve ark ise tek doz şeklinde 1 ve 15. günlerde rituksimab tedavisinin diğer tedavilerle kombine edilmesinin pemfiguslu 9 hastada etkili olduğunu göstermişler-dir (87).…”