title: Efficacy and safety of rituximab in pemphigus: experience of the German Registry of Autoimmune Diseases.
abstract: BACKGROUND
  Rituximab has been reported to be effective in various small case series of patients with severe and/or refractory pemphigus. However, no systematic evaluation is available to corroborate this observation. The aim of this study was to systematically determine efficacy and safety of rituximab in treatment-resistant pemphigus.
  
  
  METHODS
  Multicenter retrospective, observational study of 36 patients with severe pemphigus vulgaris (n = 33) and pemphigus foliaceus (n = 3) treated with rituximab before August 31(st) , 2008 and enrolled in a national observational registery between December 2008 and June 2009.
  
  
  RESULTS
  Within a mean period of observation of 11 (1-37) months, 21 (58 %) pemphigus patients showed complete, 13 (36 %) partial, and 2 (6 %) no response to rituximab treatment. This correlates with a mean improvement of the visual analog scale for well-being of 34 (20-60) at baseline to 75 (40-95) at the last control visit. In 4 (11 %) patients, severe adverse events were recorded including 1 (3 %) serious infection.
  
  
  CONCLUSIONS
  Data collected in this systematic registry indicate that rituximab is an effective and relatively safe adjuvant treatment option for refractory pemphigus. To further extend our knowledge on efficacy and safety of this drug, controlled prospective trials are required.
authors.affiliation: Department of Dermatology, University of Lübeck, Ratzeburger Allee 160, Lübeck, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Kasperkiewicz
authors.forename: Rüdiger
authors.initials: R
authors.lastname: Eming
authors.forename: Melika
authors.initials: M
authors.lastname: Behzad
authors.forename: Nicolas
authors.initials: N
authors.lastname: Hunzelmann
authors.forename: Michael
authors.initials: M
authors.lastname: Meurer
authors.forename: Hendrik
authors.initials: H
authors.lastname: Schulze-Koops
authors.forename: Peter
authors.initials: P
authors.lastname: von Wussow
authors.forename: Michael
authors.initials: M
authors.lastname: Hertl
authors.forename: Detlef
authors.initials: D
authors.lastname: Zillikens
authors.forename: Klaus
authors.initials: K
authors.lastname: Freivogel
authors.forename: Thomas
authors.initials: T
authors.lastname: Dörner
authors.forename: Enno
authors.initials: E
authors.lastname: Schmidt
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D058846:Antibodies, Monoclonal, Murine-Derived / Q000009:adverse effects* / Q000627:therapeutic use*; D015897:Comorbidity; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007155:Immunologic Factors / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010392:Pemphigus / Q000188:drug therapy* / Q000453:epidemiology*; D015995:Prevalence; D012042:Registries; D012307:Risk Factors; D000069283:Rituximab; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D007155:Immunologic Factors; D000069283:Rituximab