Adjuvant rituximab therapy of pemphigus a single-center experience with 31 patients

Luisa Lunardon, Kathleen J. Tsai, Kathleen J. Propert, Nicole Fett, John R. Stanley, Victoria P. Werth, Donald E. Tsai, Aimee S. Payne

Research output: Contribution to journalArticle

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Abstract

Background: We conducted a retrospective study of patients with pemphigus vulgaris (n=24) and foliaceus (n=7) treated with adjuvant rituximab to determine efficacy and adverse events. The end point for efficacy was complete remission of disease taking no or minimal therapy. Observations: Eighteen patients (58%) achieved the study end point. Of these, 13 patients achieved complete remission off systemic therapy. Patients achieving the study end point had a median disease duration before rituximab therapy of 19 months vs 86 months in those not achieving the end point (P=.01). For the 18 patients achieving the end point, the median (SD) duration of remission was 19 (2) months. Eight of these 18 patients (44%) relapsed from 6 to 17 months after treatment. Serious adverse events attributed to rituximab treatment (osteomyelitis or phlegmon) occurred in 2 patients (6%). In paired serum samples from 10 patients before and after rituximab treatment, the percent change in serum desmoglein index value (median, -80%) was unrelated to the percent change in pneumococcal antibodies (median, +8%) (Spearman rank correlation coefficient r=-0.2). Conclusions: Patients treated with rituximab earlier in the course of disease may have better outcomes. A discussion of rituximab's mechanism of action supports the rationale for early therapy. Prospective clinical studies are necessary to substantiate this observation.

Original languageEnglish (US)
Pages (from-to)1031-1036
Number of pages6
JournalArchives of Dermatology
Volume148
Issue number9
DOIs
StatePublished - Sep 2012
Externally publishedYes

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Pemphigus
Therapeutics
Desmogleins
Rituximab
Cellulitis
Osteomyelitis
Nonparametric Statistics
Secondary Prevention
Serum
Retrospective Studies
Prospective Studies
Antibodies

ASJC Scopus subject areas

  • Dermatology

Cite this

Lunardon, L., Tsai, K. J., Propert, K. J., Fett, N., Stanley, J. R., Werth, V. P., ... Payne, A. S. (2012). Adjuvant rituximab therapy of pemphigus a single-center experience with 31 patients. Archives of Dermatology, 148(9), 1031-1036. https://doi.org/10.1001/archdermatol.2012.1522

Adjuvant rituximab therapy of pemphigus a single-center experience with 31 patients. / Lunardon, Luisa; Tsai, Kathleen J.; Propert, Kathleen J.; Fett, Nicole; Stanley, John R.; Werth, Victoria P.; Tsai, Donald E.; Payne, Aimee S.

In: Archives of Dermatology, Vol. 148, No. 9, 09.2012, p. 1031-1036.

Research output: Contribution to journalArticle

Lunardon, L, Tsai, KJ, Propert, KJ, Fett, N, Stanley, JR, Werth, VP, Tsai, DE & Payne, AS 2012, 'Adjuvant rituximab therapy of pemphigus a single-center experience with 31 patients', Archives of Dermatology, vol. 148, no. 9, pp. 1031-1036. https://doi.org/10.1001/archdermatol.2012.1522
Lunardon, Luisa ; Tsai, Kathleen J. ; Propert, Kathleen J. ; Fett, Nicole ; Stanley, John R. ; Werth, Victoria P. ; Tsai, Donald E. ; Payne, Aimee S. / Adjuvant rituximab therapy of pemphigus a single-center experience with 31 patients. In: Archives of Dermatology. 2012 ; Vol. 148, No. 9. pp. 1031-1036.
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