SUSTAINED REMISSION OF PEMPHIGUS IN INDIAN PATIENTS WITH A MODIFIED LYMPHOMA RITUXIMAB PROTOCOL

Sharad Dattatraya Mutalik, Yashashree Rasal

Abstract


ABSTRACT:

SUSTAINED  REMISSION  OF  PEMPHIGUS  WITH  A  MODIFIED  LYMPHOMA  RITUXIMAB  PROTOCOL.

KEY WORDS:  Pemphigus,  rituximab,  long-term remission,  modified  lymphoma  protocol.

AIM:

Rituximab  is  a  proven  gratifying  therapeutic  modality  for  pemphigus  of  varying  severity. While defined guidelines for its use in pemphigus are awaited ,we treated patients with a modified lymphoma protocol of rituximab in an attempt to  add  on  to  the  search  for  an  ideal  dosing  schedule .

MATERIALS AND METHODS:

We  studied  retrospectively  a  total  of  10  patients with  pemphigus   in  a  private  practice  setup  offering  facility  of   hospitalized  care with  rituximab  as  10  infusions  over  a  period  of  7  months  with  a  mean  follow  up  period  of  5 years. Patients  had  varying  severity  of  disease  and  had  not  received  rituximab   in  the  past.

RESULTS:

Complete remission  was  observed  in  100%  patients. The  mean  time  to  disease  control  and  time  for  complete  remission  was  4.2  weeks  and  14  weeks  respectively. 4 (40%) patients  were  in  complete  remission  and  were  off  all  treatment.4 (40%) patients  were  in  complete  remission with  adjuvant  immunosuppressant. 2 (20%)  patients  experienced  relapse  after  a   mean  duration  of  2.5  years  and  were  treated  with  rituximab  again  without  corticosteroids  which  induced  new  complete  remission. No serious  adverse  effects  were  observed.

CONCLUSIONS:

Long  term  treatment  with  rituximab  for  pemphigus  of  varying  severity  over  7   months  was  safe , well  tolerated  enabling  steroid  discontinuation  and   achieving    uniform  sustained  remission  up to  5 years in  all  treated   patients.

 

 

 


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