INTERNATIONAL JOURNAL OF CLINICAL PRACTICE, vol.75, no.12, 2021 (SCI-Expanded)
Background/Aim Rituximab (RTX) and intravenous human immunoglobulin (IVIG) have been shown to be effective in the treatment of autoimmune bullous diseases (ABD), mainly pemphigus vulgaris (PV). The present study aimed to assess the clinical response of patients with ABD, mainly PV to RTX, IVIG and combined regimen of both. Whether adding IVIG to RTX therapy affects the achievement of complete remission off therapy (CR off), reduces time to CR off, time to steroid cessation, and decreases relapse rate was also investigated. Methods Data of 33 patients with ABD [PV (93.9%)], including clinical response to treatment, steroid cessation time, time to CR off and relapse, were recruited from medical charts. Results CR off and relapse rate, mean time to CR off and relapse was 86.7% (n = 13) vs 60.0% (n = 6) and 53.3% (n = 8) vs 40% (n = 4), 12.77 +/- 9.30 vs 11.25 +/- 13.40 and 24.1 +/- 16.7 vs 13.0 +/- 3.6 months in RTX and combination group, respectively. Older age (P = .005), younger age at the time of diagnosis (P = .004), lesser disease duration to the initiation of RTX (P = .004), lesser BMI (P = .026) and female gender (P = .037) were associated factors with CR off. Conclusion Adding IVIG to RTX did not increase CR off rates; it also did not decrease time to CR off, time to steroid cessation, relapse rates and did not increase time to relapse. Patient and disease characteristics, including age, younger age at the time of diagnosis, lesser disease duration before RTX treatment, lesser BMI and female gender, are factors associated with CR off.