title: Efficacy and safety of rituximab therapy in patients with pemphigus vulgaris: first report from Turkey.
abstract: BACKGROUND
  Pemphigus vulgaris (PV) is a severe, chronic, and potentially life-threatening autoimmune blistering disease that affects the skin and mucous membranes. Rituximab is a monoclonal anti-CD20 antibody which has been used increasingly in the therapy of PV.
  
  
  METHODS
  The present study sought to test the efficacy and safety of rituximab as an adjuvant therapy by retrospective analysis of clinical and immunological data for 29 patients with PV who were treated with rituximab between 2010 and 2015. Response to therapy, duration of clinical remission, serology of the response, and adverse effects of rituximab were evaluated.
  
  
  RESULTS
  The mean ± standard deviation (SD) follow-up time was 17.48 ± 13.18 months. In all patients, findings showed either a decrease in antibody titers or that antibodies were completely undetectable after therapy. Rituximab use resulted in a significant reduction in steroid dosage during follow-up. At the end of the follow-up period, 26 patients (96.2%) had achieved complete remission with or without therapy (one patient had no follow-up and one patient had died, most probably as the result of a thromboembolic event). In 44.4% of patients, a clinical relapse occurred after a mean ± SD period of 13.1 ± 4.7 months after the initiation of rituximab therapy. Relapses were managed with additional infusions of rituximab.
  
  
  CONCLUSIONS
  Rituximab is a beneficial and relatively safe adjuvant treatment for PV that facilitates prolonged clinical remission and has a significant steroid-sparing effect.
authors.affiliation: Department of Dermatology and Venereology, Faculty of Medicine, Akdeniz University, Antalya, Turkey. sonuzun@akdeniz.edu.tr, sonuzun@hotmail.com.
authors.forename: Soner
authors.initials: S
authors.lastname: Uzun
authors.affiliation: Department of Dermatology and Venereology, Faculty of Medicine, Akdeniz University, Antalya, Turkey.
authors.forename: Aslı
authors.initials: A
authors.lastname: Bilgiç Temel
authors.affiliation: Department of Dermatology and Venereology, Faculty of Medicine, Akdeniz University, Antalya, Turkey.
authors.forename: Ayşe
authors.initials: A
authors.lastname: Akman Karakaş
authors.affiliation: Department of Dermatology and Venereology, Faculty of Medicine, Akdeniz University, Antalya, Turkey.
authors.forename: Erkan
authors.initials: E
authors.lastname: Ergün
authors.affiliation: Department of Dermatology and Venereology, Faculty of Medicine, Akdeniz University, Antalya, Turkey.
authors.forename: Birgül
authors.initials: B
authors.lastname: Özkesici
authors.affiliation: Department of Dermatology and Venereology, Faculty of Medicine, Akdeniz University, Antalya, Turkey.
authors.forename: Ali Haydar
authors.initials: AH
authors.lastname: Eskiocak
authors.affiliation: Department of Dermatology and Venereology, Faculty of Medicine, Akdeniz University, Antalya, Turkey.
authors.forename: Ayşegül
authors.initials: A
authors.lastname: Erat
authors.affiliation: Department of Dermatology and Venereology, Faculty of Medicine, Akdeniz University, Antalya, Turkey.
authors.forename: Nilay
authors.initials: N
authors.lastname: Uğurlu
authors.affiliation: Department of Dermatology and Venereology, Faculty of Medicine, Akdeniz University, Antalya, Turkey.
authors.forename: Berna
authors.initials: B
authors.lastname: Nazlım
authors.affiliation: Department of Dermatology and Venereology, Faculty of Medicine, Akdeniz University, Antalya, Turkey.
authors.forename: Saliha
authors.initials: S
authors.lastname: Koç
authors.affiliation: Department of Biostatistics and Medical Informatics, Faculty of Medicine, Akdeniz University, Antalya, Turkey.
authors.forename: Selen
authors.initials: S
authors.lastname: Bozkurt
authors.affiliation: Department of Dermatology and Venereology, Faculty of Medicine, Akdeniz University, Antalya, Turkey.
authors.forename: Özlem
authors.initials: Ö
authors.lastname: Dicle
authors.affiliation: Department of Dermatology and Venereology, Faculty of Medicine, Akdeniz University, Antalya, Turkey.
authors.forename: Erkan
authors.initials: E
authors.lastname: Alpsoy
authors.affiliation: Department of Dermatology and Venereology, Faculty of Medicine, Akdeniz University, Antalya, Turkey.
authors.forename: Ertan
authors.initials: E
authors.lastname: Yılmaz
mesh_terms: D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D001323:Autoantibodies / Q000097:blood*; D051183:Desmoglein 1 / Q000276:immunology; D051184:Desmoglein 3 / Q000276:immunology; D018572:Disease-Free Survival; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007155:Immunologic Factors / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage; D008875:Middle Aged; D010392:Pemphigus / Q000097:blood* / Q000188:drug therapy*; D012008:Recurrence; D012074:Remission Induction; D012189:Retrospective Studies; D000069283:Rituximab / Q000009:adverse effects / Q000627:therapeutic use*; D012720:Severity of Illness Index; D014421:Turkey; D055815:Young Adult
chemical_list: D000893:Anti-Inflammatory Agents; D001323:Autoantibodies; C495297:DSG1 protein, human; C071894:DSG3 protein, human; D051183:Desmoglein 1; D051184:Desmoglein 3; D007074:Immunoglobulin G; D007155:Immunologic Factors; D000069283:Rituximab; D008775:Methylprednisolone