Objective: The aim of the study was to evaluate the efficacy and safety of rituximab treatment in patients with pemphigus vulgaris.
Materials and Methods: Seventeen patients who received rituximab treatment with the diagnosis of pemphigus vulgaris were included in the study. Rituximab was administered according to rheumatoid arthritis protocol. The patient demographic and clinical information, disease duration, previous treatments, additional diseases, disease course after rituximab, and side effects were evaluated retrospectively by scanning patient files.
Results: The average age of patients was 49.1±12.1-years-old. In 3 (17.6%) patients, the drug regime could not be completed due to the reaction that developed during the infusion. One of the 14 patients who were treated could not be followed up due to exitus. Complete remission occurred in all 13 patients who were followed up, and the median duration of complete remission was 4.2 months (min: 2, and max: 13 months); however, 6 (45.1%) patients relapsed within an average of 11±3.7 months. Examination of the pemphigus disease area index (PDAI) scores shows that the pre-rituximab values in the 13 patients were between 12 and 65 (mean 28.6±15.9), while those in 12 patients were zero at the past follow-up, with only one patients PDAI value being calculated as 20. As side effects, infusion reaction in three patients, lymphopenia in five patients, herpetic keratitis in one patient, cerebritis, sepsis, and death due to intracranial hemorrhage occurred in one patient.
Conclusion: It can be concluded that rituximab treatment was effective in pemphigus vulgaris; however, it is necessary to be careful in terms of side effects such as lymphopenia and infection.