REVIEW article
Front. Immunol.
Sec. Autoimmune and Autoinflammatory Disorders : Autoimmune Disorders
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1605243
This article is part of the Research TopicThe pathogenesis and novel treatment options in AIBDsView all 5 articles
Efficacy and Safety of low dose rituximab in pemphigus: An updated systematic review and meta-analysis
Provisionally accepted
- Peking Union Medical College Hospital (CAMS), Beijing, China
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Objective: To evaluate the efficacy and safety of low-dose rituximab (RTX) in the treatment of pemphigus.Methods: A systematic literature search was conducted across PubMed, Embase, Web of Science, the Cochrane Library, and ClinicalTrials.gov to identify eligible studies. Primary efficacy outcomes included complete remission (CR), relapse rates, time to disease control (TDC), time to CR, and cumulative corticosteroid dose. Safety outcomes were assessed by meticulously documenting adverse events (AEs) and concomitant medications reported in each study.Results: The final analysis incorporated five comparative studies and nine single-arm studies investigating the efficacy and safety outcomes of low-dose RTX. Comparative data revealed no statistically significant differences between the high-dose and low-dose RTX groups in CR, relapse rates, TDC, time to CR, and cumulative corticosteroid dose. In single-arm studies, pooled CR and relapse rates were 63.2% and 28.6%, respectively. No fatal events were reported; however, severe AEs, including pneumonia and sepsis, were documented in the low-dose RTX cohort. Conclusion: Low-dose RTX exhibited comparable clinical efficacy to high-dose RTX regimens in pemphigus management. However, clinicians should remain vigilant for potential AEs associated with low-dose RTX infusion.
Keywords: Meta-analysis, Pemphigus, rituximab, Safety, treatment outcome
Received: 03 Apr 2025; Accepted: 20 Jun 2025.
Copyright: © 2025 Liu, Wang and Zuo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Ya-gang Zuo, Peking Union Medical College Hospital (CAMS), Beijing, China
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