Comparing Clinical Outcomes of Steroid-Sparing Therapy With Rituximab Versus Rituximab Alone in Pemphigus.

Area of Science:

• Immunodermatology
• Autoimmune Blistering Diseases

Background:

• Rituximab therapy shows promise for autoimmune blistering diseases.
• Steroid-sparing therapy (SST) combined with rituximab improved outcomes in mucous membrane pemphigoid.
• Limited data exists on SST's role in pemphigus treatment with rituximab.

Purpose of the Study:

• To evaluate clinical outcomes in pemphigus patients treated with rituximab, with or without SST.
• To compare remission rates, prednisone reduction, and relapse times between the two treatment groups.

Main Methods:

• Retrospective chart review of adult pemphigus patients (2011-2021).
• Comparison of primary outcomes: time to remission, time to low-dose prednisone, time to prednisone cessation, and time to relapse.
• Patients were stratified into groups receiving rituximab with SST and rituximab without SST.

Main Results:

• No significant difference in time to remission between groups.
• No difference in time to achieve prednisone dose of 10 mg or less.
• No difference in time to cessation of prednisone therapy or time to relapse after rituximab.
• Steroid-sparing therapy (SST) did not improve clinical outcomes when used with rituximab in pemphigus patients.

Conclusions:

• The addition of SST to rituximab therapy did not enhance clinical outcomes for pemphigus patients.
• These findings suggest rituximab monotherapy may be sufficient for most pemphigus patients.
• Further research could explore specific patient subgroups that might benefit from combined therapy.