Successful treatment of pemphigus with biweekly 1-g infusions of rituximab: A retrospective study of 47 patients - 09/02/13
Abstract |
Background |
Rituximab is increasingly being appreciated as a remarkably effective treatment for pemphigus, mostly concomitantly with other immunosuppressive medications. The majority of studies have used a single cycle of rituximab with the same dosage as approved for the treatment of lymphomas, ie, 375 mg/m2 weekly × 4 weeks. Rituximab is also approved for the treatment of rheumatoid arthritis, with a different dosing regimen: 1000 mg × 2, days 1 and 15.
Objective |
We aimed to assess the clinical response of patients with pemphigus to a single cycle of rituximab at the dosage used in rheumatoid arthritis. We also evaluated the response to repeated cycles of rituximab.
Methods |
A total of 47 patients with pemphigus who were treated with rituximab at a dosage of 1000 mg × 2, days 1 and 15, most with concurrent immunosuppressive medications, were retrospectively studied.
Results |
Remission rates after the first treatment cycle reached 76%. Repeating the treatment further increased the remission rates to 91%. There was a 22% relapse rate at a median time of 8 months, but 75% of relapsing patients achieved remission again with additional cycles. The side-effect profile was similar to previous reports, except for an immediate postinfusion pemphigus exacerbation in 4 patients.
Limitations |
This was a retrospective study with a limited follow-up period.
Conclusion |
The rheumatoid arthritis dosage of rituximab was efficacious and well tolerated in patients with pemphigus. Patients who fail to achieve remission after 1 cycle or patients who relapse seem to benefit from repeated rituximab cycles.
Le texte complet de cet article est disponible en PDF.Key words : autoimmune bullous disease, pemphigus, rheumatoid arthritis, rituximab, treatment
Abbreviations used : CR, PCP, PR, RA
Plan
Funding sources: None. |
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Conflicts of interest: None declared. |
Vol 68 - N° 3
P. 404-411 - mars 2013 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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