Rituximab Works for Pemphigus: What Australian Data Show

Doctors around the world often use rituximab as the first choice for moderate to severe pemphigus. In Australia, the guidelines see it more as a backup option when other treatments fail. Local data on how well it works have been scarce.

Researchers looked at one Australian hospital's records. They found 24 adults who had been given rituximab as part of their regular care. Sixteen had pemphigus vulgaris and eight had pemphigus foliaceus. The average time they were watched after the first dose was about two and a half years.

Every patient showed some level of disease control. Twenty people, which is about eighty three percent, reached complete remission. Half of those who remitted later saw the disease come back, even though most got more than one round of the drug. Side effects appeared in eight patients, roughly one third of the group. Most were mild reactions to the infusion, but one patient died from a serious pneumonia.

These findings suggest that giving rituximab just once may not be enough. Planning ongoing treatment after remission could keep the disease away longer. Experts say a larger study with many centers and a standard way to measure severity would help confirm the best approach.