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Arch Dermatol. 2012 Jun;148(6):734-9. doi: 10.1001/archdermatol.2011.3320.

Effect of a single-cycle alternative dosing regimen for rituximab for recalcitrant pemphigus: a case series of 9 patients.

Author information

  • 1Division of Dermatology, Sunnybrook Health Sciences Center and Women’s College Hospital, University of Toronto, Toronto, Ontario, Canada. konaotake1117@yahoo.co.jp

Erratum in

  • Arch Dermatol. 2012 Sep 1;148(9):1012. Dosage error in article text.
  • Arch Dermatol. 2012 Aug;148(8):970. Dosage error in article text.

Abstract

BACKGROUND:

There is increasing evidence that a single cycle of rituximab (375 mg per square meter [corrected] of body surface area once weekly for 4 weeks) is efficacious in patients with severe pemphigus. The approved protocol in rheumatoid arthritis is 1 g on days 1 and 15. We report herein on the efficacy and safety of this latter protocol for rituximab in 9 patients with pemphigus.

OBSERVATIONS:

Nine patients with recalcitrant pemphigus were treated with prednisone, immunosuppressive agents, and/or intravenous immunoglobulin. Rituximab, 1 g, was infused on days 1 and 15. Each patient was observed for a minimum of 6 months. Reepithelialization of at least 50% of the affected areas occurred in all patients within 16 weeks. Three of 6 patients (50%) discontinued intravenous immunoglobulin therapy. A significant decrease in the pemphigus severity score and the mean dosage of prednisone was observed at 3 and 6 months. Relapses were observed in 4 patients between 5 and 13 months after rituximab treatment; these patients completed a second cycle of rituximab. There were no serious adverse effects observed during the follow-up period.

CONCLUSIONS:

A single cycle of rituximab, 1 g on days 1 and 15, is an effective treatment for pemphigus. Further studies are needed to determine the efficacy and safety of repeated treatment courses in patients who experience recurrences.

PMID:
22351790
[PubMed - indexed for MEDLINE]
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