ArticleThe Journal of dermatology2026
Real-World Experience With Single Ultra-Low Dose Rituximab for Remission Induction in Pemphigus.
Article in The Journal of dermatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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4 authors.
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Abstract
Standard-dose rituximab (SDRTX) is the established treatment for pemphigus, but optimization of cost-effectiveness and safety remains desirable. We retrospectively evaluated the efficacy of a single ultra-low dose RTX infusion (ULRTX; 100 or 200 mg) for remission induction in 12 patients with mild-to-severe pemphigus (median baseline Pemphigus Disease Area Index [PDAI] 29.5). 9 patients (75%) achieved complete remission on minimal therapy (CRMT), and among them 5 (41.7%) subsequently achieved complete remission off therapy (CROT), with a median time to CRMT and CROT of 24 weeks and 61 weeks, respectively. Significant corticosteroid sparing was achieved; 9 of 10 evaluable patients tapered prednisolone to ≤ 5 mg/day within 6 months. Despite the reduced dose of RTX, an overall decline in serum anti-desmoglein 1 and 3 IgG titers and effective peripheral B-cell depletion (≤ 1%) occurred in evaluable patients. However, early B-cell repopulation was observed in one patient who experienced an early relapse. Compared with the standard-dose group (n = 8), the ULRTX group demonstrated a favorable safety profile with significantly fewer drug-related adverse events (0% vs. 37.5%, p = 0.049), while maintaining effective clinical remission. Single-dose ULRTX appears to be a cost-efficient and biologically effective induction strategy, supporting a personalized, immunologically guided, on-demand treatment approach.
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