title: Clinical efficacy of different doses of rituximab in the treatment of pemphigus: a retrospective study of 27 patients.
abstract: BACKGROUND
  The treatment of pemphigus is still challenging and some patients with pemphigus are unresponsive to conventional immunosuppressive treatments. Rituximab, a chimeric monoclonal anti-CD20 antibody, binds to the CD20 antigen on the surface of B cells and has been reported to be effective for the treatment of recalcitrant pemphigus.
  
  
  OBJECTIVE
  To compare the efficacy of different doses of rituximab in patients with pemphigus who were unresponsive to conventional therapies.
  
  
  METHODS
  Twenty-seven patients with pemphigus who received different doses of rituximab (375 mg m(-2) per infusion weekly) were analysed retrospectively. We divided the patients into two groups: group 1 (n = 12) received two infusions of rituximab and group 2 (n = 15) received three or more infusions of rituximab at 1-week intervals. The number of infusions was determined by the choice of each patient. The endpoints of the study were time to disease control, partial remission (PR) and complete remission (CR).
  
  
  RESULTS
  There was no significant difference in time to achieve PR between the two groups (147 vs. 135 days, P = 0·65). However, group 2 demonstrated better outcomes than group 1 in time to CR (443 vs. 149 days, P = 0·06) and relapse rate (0% vs. 67%, P < 0·01).
  
  
  CONCLUSIONS
  We conclude that three or more infusions of rituximab are more effective than two infusions for the treatment of pemphigus.
authors.affiliation: Department of Dermatology and Cutaneous Biology Research Institute, Yonsei University College of Medicine, Gangnam Severance Hospital, 712 Eonjuro, Gangnam-gu, Seoul 135-720, Korea.
authors.forename: J H
authors.initials: JH
authors.lastname: Kim
authors.forename: Y H
authors.initials: YH
authors.lastname: Kim
authors.forename: M R
authors.initials: MR
authors.lastname: Kim
authors.forename: S-C
authors.initials: SC
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage*; D002908:Chronic Disease; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007155:Immunologic Factors / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D010392:Pemphigus / Q000188:drug therapy*; D012008:Recurrence; D012189:Retrospective Studies; D000069283:Rituximab; D016896:Treatment Outcome
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D007155:Immunologic Factors; D000069283:Rituximab