New research shows rituximab infusion at six months significantly reduced relapse risk in patients with pemphigus who had predictors of relapse.
Researchers for the multicenter cohort study conducted in France included 87 patients with pemphigus in the analysis, 64 of whom had pemphigus vulgaris and 23 had pemphigus foliaceus. All patients were treated using the RITUX 3 regimen. At month six, 77 patients achieved complete remission (CR), but 30 of them had predictors of relapse, such as a Pemphigus Disease Area Index (PDAI) score of 45 or higher or elevated levels of anti-desmoglein antibodies (DSG1 or DSG3). These patients received an additional rituximab infusion at month six.
By month 12, the rate of CR without corticosteroid therapy was 93.5% among patients in remission at month six, compared with 82.7% for the entire study cohort. Relapse occurred in only two patients, none of whom had received the additional infusion. The overall relapse rate was 2.6%, with a number needed to treat (NNT) of 3.6 to prevent one relapse.
"This multicenter cohort study indicates that using predictors such as baseline PDAI score, anti-DSG1 antibodies, and/or anti-DSG3 antibodies to initiate preemptive treatment with additional rituximab may reduce the rate of short-term relapse," the authors wrote.
Source: Herbert V, et al. JAMA Dermatology. 2025. Doi:10.1001/jamadermatol.2024.6130