Pemphigus: which factors predict remission after rituximab?

  • Kushner CJ & al.
  • JAMA Dermatol
  • 23 oct. 2019

  • de Brian Richardson, PhD
  • Clinical Essentials
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Takeaway

  • Dose regimen, age, and BMI are associated with odds of complete remission after rituximab therapy in patients with pemphigus.

Why this matters

  • Rituximab is a first-line treatment for pemphigus, but predictors of remission had not been identified.

Key results

  • 70.5% of patients achieved complete remission off therapy (CROT).
  • 48.2% of patients achieved CROT after the first cycle of rituximab.
  • Patients who received higher rituximab dose (lymphoma dose [375 mg/m2 weekly for 4 weeks]) vs rheumatoid arthritis dose (1000-mg infusions 14 days apart) were more likely to achieve CROT (OR, 2.70; P=.04).
  • Older age was associated with achieving CROT (OR, 4.95 [P=.01] for ages 45.0-54.9 years; OR, 3.69 [P<.047 for ages years or age compared with p=".01" trend>
  • BMI ≥35 kg/m2 was associated with reduced odds of achieving CROT (OR, 0.14; P=.01).

Study design

  • 112 patients with pemphigus who were treated with rituximab were included.
  • Funding: Veterans Health Administration.

Limitations

  • Retrospective study design.
  • Small patient sample size.