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Rituximab + Prednisone Yields Lasting Complete Remission in Pemphigus

Relapses occurred in 42.2 and 83.7 percent of patients receiving rituximab plus prednisone versus prednisone alone

By Dermsquared Editorial Team | January 24, 2024

WEDNESDAY, Jan. 24, 2024 -- For patients with pemphigus, rituximab plus prednisone (Ritux 3 regimen) is associated with long-term sustained complete remission, according to a study published online Jan. 24 in JAMA Dermatology.

Billal Tedbirt, M.D., from Normandie University in Rouen, France, and colleagues examined the long-term efficacy and safety of Ritux 3 treatment in a seven-year follow-up study of the Ritux 3 trial involving 90 patients with pemphigus. Patients were initially randomly assigned to the rituximab plus prednisone group or prednisone-alone group; 44 and 39, respectively, were evaluated at the end of follow-up.

The researchers found that 93 and 39 percent of patients from the rituximab plus prednisone and prednisone-alone groups, respectively, achieved complete remission without corticosteroids at any time during follow-up. Five- and seven-year disease-free survival occurred in 76.7 and 72.1 percent of patients, respectively, in the rituximab group compared with 35.3 and 35.3 percent in the prednisone-alone group; relapses occurred in 42.2 and 83.7 percent, respectively. Shorter disease-free survival occurred for patients who received rituximab as second-line treatment compared with those who received rituximab as first-line. Fewer severe adverse events occurred in the rituximab plus prednisone versus prednisone-alone groups (31 versus 58; 0.67 and 1.32 per patient, respectively).

"This study showed that the first-line treatment of patients with pemphigus with rituximab was associated with sustained complete remission without corticosteroids therapy up to seven years after the start of treatment," the authors write.

Several authors disclosed ties to the pharmaceutical industry.

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