Background

Rituximab (RTX) is an effective therapy for patients with pemphigus; however, the therapy does not prevent relapse.

Objectives

To compare early relapsing patients (before 12 months) and late relapsing patients (after 24 months) following RTX therapy.

Method

In this prospective study, 19 patients were enrolled (14 with pemphigus vulgaris and 5 with pemphigus foliaceus). The baseline disease score, autoantibody levels, and percentage of CD20⁺ cells of patients with pemphigus were measured. Patients received 1 cycle of RTX and were followed for 26 months.

Results

Among early relapsing patients (n = 5), the time to relapse was 6 to 11 months. Among late relapsing patients (n = 6), the time to relapse was 24 to 26 months. A significant difference was observed in the mean baseline anti–desmoglein 1 (DSG1) index between early relapsing (705.72) and late relapsing patients (210.4) (P = .0014). A significant negative correlation was found between the baseline anti-DSG1 index and time to relapse (r = −0.777, P = .00009).

Limitations

The small number of patients with pemphigus foliaceus.

Conclusions

Because patients with high baseline anti-DSG1 indices relapsed earlier, it may be important to follow these patients closely for the initial 12 months after RTX therapy. These patients may require a maintenance RTX dose during the first 12 months after RTX therapy.

中文翻译：

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一项前瞻性研究比较利妥昔单抗治疗的早期和晚期复发性天疱疮患者

背景

利妥昔单抗（RTX）是一种治疗天疱疮的有效方法。但是，该疗法不能预防复发。

目标

比较RTX治疗后早期复发患者（12个月前）和晚期复发患者（24个月后）。

方法

在这项前瞻性研究中，共招募了19例患者（其中寻常型天疱疮14例，叶性天疱疮5例）。测量了天疱疮患者的基线疾病评分，自身抗体水平和CD20 ⁺细胞百分比。患者接受了1个RTX周期，并随访了26个月。

结果

在早期复发患者（n = 5）中，复发时间为6至11个月。在晚期复发患者（n = 6）中，复发时间为24到26个月。早期复发患者（705.72）和晚期复发患者（210.4）之间的平均基线抗桥粒芯蛋白1（DSG1）指数存在显着差异（P  = .0014）。发现基线抗DSG1指数与复发时间之间存在显着的负相关性（r  = -0.777，P  = .00009）。

局限性

少数患者有叶天疱疮。

结论

由于基线抗DSG1指数高的患者较早复发，因此在RTX治疗后最初的12个月内密切随访这些患者可能很重要。这些患者在RTX治疗后的前12个月内可能需要维持RTX剂量。