People with pemphigus with severe disease and those with persistent anti-desmoglein (DSG) antibodies three months after starting treatment with rituximab are more prone to relapse while on the drug, a study shows.

The findings come from a post-hoc analysis of the RITUX 3 trial, in which 90 patients were randomly assigned to 1000 mg IV rituximab at baseline and two weeks, followed by 500mg infusions at 12 and 18 months, plus short-term prednisone (0.5 mg/kg daily for moderate pemphigus, double the dose for severe disease), or to an arm that received short-term prednisone only.

At two years, 89% of patients who received rituximab were in full remission without treatment, compared to 34% of those who received corticosteroids only.

There were 11 relapses (23%) in the rituximab group and 20 (46%) in the standard treatment group.