Evaluation of the efficacy and safety of rituximab in patients with refractory pemphigus vulgaris

Background: recently, rituximab has been successfully used forthe treatment of pemphigus family, the main subtype of which ispemphigus vulgaris (pv). the aim of this study was to determinethe efficacy and safety of rituximab in refractory pv.methods: in an observational study extending from november2014 to february 2016, 30 patients with refractory pv weretreated with rituximab. response to therapy, duration of clinicalremission, relapse rate, serology, and side effects of treatmentwith rituximab were evaluated.results: at the end of the follow-up with a mean duration of 7.6(6-14) months, 25 (83.3%) patients achieved complete remissionwith or without systemic therapy. the mean duration of diseasecontrol was 2.8 months. in all patients, the serum levels of antidesmoglein1 and 3 igg antibodies were reduced after rituximabtherapy. in 23.4% of the patients, a clinical relapse occurred ata mean of 9.6 months following the initiation of the treatment.infusion-related reactions occurred in 18 (60%) patients. thelack of a control group, concomitant use of corticosteroid andimmunosuppressive agents, and a limited follow-up period wereamong the limitations of our research.conclusions: rituximab is a good treatment modality for refractorypv, which extends the mean time to relapse in patients. to furtherextend our knowledge on the efficacy and safety of rituximabtherapy, more randomized controlled trials with larger samplesizes and prolonged follow-up durations are required.