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Most patients with pemphigus refractory to corticosteroid therapy improve with administration of rituximab. Studies demonstrating this use were open-label trials that used a dosing regimen based on oncology treatment of non-Hodgkin B-cell lymphoma — 375 mg/mm2 given weekly for 4 weeks. Whether lower doses or alternate schedules might be equally effective is unknown.
Kim and colleagues1 evaluated two different doses of rituximab in 27 patients with pemphigus. Twelve patients received two infusions in one week and 15 received three or more infusions in that time. The patients treated with three or more infusions had a shorter time to complete response and a greater chance of remission (66.6% vs. 0%).
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