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Efficacy and Tolerability of Rituximab in Patients With Pemphigus Foliaceus: A Single-Centre Retrospective Cohort Study Publisher



Sadeghinia A ; Tavasoli M ; Vafaeian A ; Emadi S N ; Aryanian Z ; Daneshpazhooh M
Authors

Source: Skin Health and Disease Published:2026


Abstract

Background: Pemphigus foliaceus (PF), a rare autoimmune blistering disease, still lacks a well-established optimal treatment approach. Rituximab (RTX) is not yet approved by the US Food and Drug Administration for the treatment of PF. Objectives: To evaluate the efficacy and tolerability of RTX in treating PF. Methods: In this study, all patients diagnosed with PF and treated with RTX and referred to a tertiary hospital over a period of 7 years were included. Clinical outcomes were retrospectively evaluated using Pemphigus Disease Area Index (PDAI) scores and prednisolone dosages at a minimum of four follow-up points. Patients were divided into two groups: newly diagnosed (NDP) and previously treated patients (PTP). Comparative analyses were performed across follow-up visits and study groups. Results: A total of 96 patients were included. Significant decreases in PDAI scores and prednisolone dosages were observed for all patients (both P < 0.0001), with no significant differences found between the study groups during a 12-month follow-up period. The NDP group exhibited a higher rate of complete remission (P = 0.03) and a shorter time to complete remission (P = 0.006) compared with the PTP group. There were no significant variations in relapse rate and time to relapse among the study groups. The most common treatment-related adverse effects of RTX were those associated with the injection, which could be managed with supportive care. Conclusions: RTX emerges as a promising therapeutic option with minimal side effects for the treatment of PF. © The Author(s) 2026. Published by Oxford University Press on behalf of British Association of Dermatologists. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
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