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Rituximab Effective to Treat Severe Pemphigus

However, its use should be limited due to potential for life-threatening side effects

WEDNESDAY, Aug. 8 (HealthDay News) -- A single cycle of rituximab can be effective for treating patients with severe pemphigus who are not responding to corticosteroids, according to a report in the Aug. 9 issue of the New England Journal of Medicine. However, its use should be limited due to the drug's potentially life-threatening side effects.

Pascal Joly, M.D., Ph.D., from Rouen University Hospital in Rouen, France, and colleagues treated 21 patients with severe pemphigus that was corticosteroid-refractory or corticosteroid-dependent, or who had contraindications to corticosteroids, with four weekly infusions of rituximab (375 mg per square meter of body-surface area).

After three months, 18 patients (86 percent) had a complete remission, defined as epithelialization of all skin and mucosal lesions. Although nine patients relapsed after a mean of 18.9 months, 18 patients were disease-free after a median follow-up of 34 months. Eight patients were not taking corticosteroids, and the mean prednisone dose fell in patients taking corticosteroids. One patient developed pyelonephritis and another died from septicemia.

The study "supports previous reports that describe the beneficial effects of rituximab in the treatment of pemphigus without the need for infusions of intravenous immune globulins; however, its use must be restricted to a limited number of patients with pemphigus vulgaris or pemphigus foliaceus that is not responsive to conventional therapy…or to patients in whom these drugs may be harmful," states an accompanying editorial.

The study was partially supported by Roche.

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