Liu Si-Han, Wang Si-Hang, Zuo Ya-Gang
Department of Dermatology, State Key Laboratory of Complex Severe and Rare Diseases, National Clinical Research Center for Dermatologic and Immunologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Front Immunol. 2025 Jul 25;16:1605243. doi: 10.3389/fimmu.2025.1605243. eCollection 2025.
To evaluate the efficacy and safety of low-dose rituximab (RTX) in the treatment of pemphigus.
A systematic literature search was conducted across PubMed, Embase, 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.
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.
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.
评估低剂量利妥昔单抗（RTX）治疗天疱疮的疗效和安全性。
在PubMed、Embase、Cochrane图书馆和ClinicalTrials.gov上进行系统的文献检索，以确定符合条件的研究。主要疗效指标包括完全缓解（CR）、复发率、疾病控制时间（TDC）、达到CR的时间和累积皮质类固醇剂量。通过仔细记录每项研究中报告的不良事件（AE）和伴随用药来评估安全性指标。
最终分析纳入了五项比较研究和九项单臂研究，以调查低剂量RTX的疗效和安全性指标。比较数据显示，高剂量和低剂量RTX组在CR、复发率、TDC、达到CR的时间和累积皮质类固醇剂量方面无统计学显著差异。在单臂研究中，汇总的CR率和复发率分别为63.2%和28.6%。未报告致命事件；然而，低剂量RTX队列中记录了包括肺炎和败血症在内的严重AE。
在天疱疮治疗中，低剂量RTX与高剂量RTX方案具有相当的临床疗效。然而，临床医生应警惕与低剂量RTX输注相关的潜在AE。
