Sustained Remission Without Corticosteroids Among Patients With Pemphigus Who Had Rituximab as First-Line Therapy

• DOI: 10.1001/jamadermatol.2023.5679
• Publication Date: 2024-01-24T16:01:05Z
• Authors: Billal Tedbirt; Maud Maho-Vaillant; Estelle Houivet; Claire Mignard; Marie-Laure Golinski; Sébastien Calbo; Catherine Prost-S...; Bruno Labeille; Catherine Picard-...; Guillaume Chaby; Marie-Aleth Richard; Emmanuelle Tancre...; Sophie Duvert-Leh...; Emmanuel Delaporte; Philippe Bernard; Frédéric Caux; Marina Alexandre; Philippe Musette; Saskia Ingen-Hous...; Pierre Vabres; Gaëlle Quereux; Alain Dupuy; Sébastien Debarbieux; Martine Avenel-Au...; Michel D’Incan; Christophe Bédane; Nathalie Bénéton; Denis Jullien; Nicolas Dupin; Laurent Misery; Laurent Machet; Marie Beylot-Barry; Olivier Dereure; Bruno Sassolas; Jacques Benichou; Pascal Joly; Vivien Hébert
• Keywords: Regimen

Importance The Ritux 3 trial demonstrated the short-term efficacy and safety of first-line treatment with rituximab compared a standard corticosteroid regimen in pemphigus. No data on long-term follow-up patients who received as first line are available. Objective To assess regimen. Design, Setting, Participants This 7-year study included pemphigus from 25 dermatology departments France January 1, 2010, to December 31, 2015. Exposure Patients were initially randomized plus prednisone group or prednisone-alone group. Main outcomes measures primary outcome was 5- disease-free survival (DFS) without corticosteroids, assessed by Kaplan-Meier curves. Secondary occurrence relapse, severe adverse events (SAEs), evolution antidesmoglein (Dsg) antibody enzyme-linked immunosorbent assay values predict relapse. Results Of 90 trial, 83 evaluated at end visit (44 group; 39 group) median (IQR) 87.3 (79.1-97.5) months. Forty-three (93%) 17 (39%) had achieved complete remission corticosteroids any time during follow-up. much longer DFS than (76.7% 72.1% vs 35.3% 35.3%, respectively; P < .001), about half relapses (42.2% 83.7%; .001). second-line shorter treated ( = .007). Fewer SAEs reported group, 31 58 respectively, corresponding 0.67 1.32 per patient, respectively .003). combination anti-Dsg1 20 more IU/mL and/or anti-Dsg3 48 yielded 0.83 positive predictive value 0.94 negative Conclusions Relevance In this secondary analysis trail, associated sustained therapy additional maintenance infusion rituximab.