Development of Antirituximab Antibodies May Portend Therapy Failure in Patients with Pemphigus

Rituximab is a chimeric antibody that appears to be useful in the management of pemphigus. However, antichimeric antibodies might develop in treated patients, and if so, the implications of this development are not understood.

These authors report outcomes in 11 pemphigus patients who were treated with rituximab therapy, in 2 of whom antirituximab antibodies developed. These two patients did not experience more than partial remission, and eventually, they had increased disease activity. Their outcomes contrast sharply with outcomes in the nine patients who did not develop these antibodies. Of those patients, five had complete response and four had partial remission without a subsequent increase in disease activity.