{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T04:43:43Z","timestamp":1793853823174,"version":"4.6.1"},"reference-count":17,"publisher":"American Medical Association (AMA)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Dermatol"],"published-print":{"date-parts":[[2024,3,1]]},"abstract":"\n Importance<\/jats:title>\n The Ritux 3 trial demonstrated the short-term efficacy and safety of first-line treatment with rituximab compared with a standard corticosteroid regimen in pemphigus. No data on the long-term follow-up of patients who received rituximab as first line are available.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To assess the long-term efficacy and safety of the Ritux 3 treatment regimen.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This 7-year follow-up study of the Ritux 3 trial included patients with pemphigus from 25 dermatology departments in France from January 1, 2010, to December 31, 2015.<\/jats:p>\n <\/jats:sec>\n \n Exposure<\/jats:title>\n Patients were initially randomized in the rituximab plus prednisone group or prednisone-alone group.<\/jats:p>\n <\/jats:sec>\n \n Main outcomes and measures<\/jats:title>\n The primary outcome was the 5- and 7-year disease-free survival (DFS) without corticosteroids, assessed by Kaplan-Meier curves. Secondary outcomes were occurrence of relapse, occurrence of severe adverse events (SAEs), and evolution of antidesmoglein (Dsg) antibody enzyme-linked immunosorbent assay values to predict long-term relapse.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Of the 90 patients in the Ritux 3 trial, 83 were evaluated at the end of follow-up study visit (44 in the rituximab plus prednisone group; 39 in the prednisone-alone group) with a median (IQR) follow-up of 87.3 (79.1-97.5) months. Forty-three patients (93%) from the rituximab plus prednisone and 17 patients (39%) from the prednisone-alone group had achieved complete remission without corticosteroids at any time during the follow-up. Patients from the rituximab group had much longer 5- and 7-year DFS without corticosteroids than patients from the prednisone-alone group (76.7% and 72.1% vs 35.3% and 35.3%, respectively;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001), and had about half the relapses (42.2% vs 83.7%;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001). Patients who received rituximab as second-line treatment had shorter DFS than patients treated as first line (\n P<\/jats:italic>\n \u2009=\u2009.007). Fewer SAEs were reported in the rituximab plus prednisone group compared with the prednisone-alone group, 31 vs 58 respectively, corresponding to 0.67 and 1.32 SAEs per patient, respectively (\n P<\/jats:italic>\n \u2009=\u2009.003). The combination of anti-Dsg1 values of 20 or more IU\/mL and\/or anti-Dsg3 values of 48 or more IU\/mL yielded 0.83 positive predictive value and 0.94 negative predictive value to predict long-term relapse.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this secondary analysis of the Ritux 3 trail, first-line treatment of patients with pemphigus with the Ritux 3 regimen was associated with long-term sustained complete remission without corticosteroid therapy without any additional maintenance infusion of rituximab.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamadermatol.2023.5679","type":"journal-article","created":{"date-parts":[[2024,1,24]],"date-time":"2024-01-24T11:01:05Z","timestamp":1706094065000},"page":"290","source":"Crossref","is-referenced-by-count":39,"title":["Sustained Remission Without Corticosteroids Among Patients With Pemphigus Who Had Rituximab as First-Line Therapy"],"prefix":"10.1001","volume":"160","author":[{"given":"Billal","family":"Tedbirt","sequence":"first","affiliation":[{"name":"Department of Dermatology, CHU Rouen and INSERM U1234, Normandie University, Rouen, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maud","family":"Maho-Vaillant","sequence":"additional","affiliation":[{"name":"Department of Dermatology, CHU Rouen and INSERM U1234, Normandie University, Rouen, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Estelle","family":"Houivet","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Clinical Research, CHU Rouen, Rouen, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Mignard","sequence":"additional","affiliation":[{"name":"Department of Dermatology, CHU Rouen and INSERM U1234, Normandie University, Rouen, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie-Laure","family":"Golinski","sequence":"additional","affiliation":[{"name":"Department of Dermatology, CHU Rouen and INSERM U1234, Normandie University, Rouen, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00e9bastien","family":"Calbo","sequence":"additional","affiliation":[{"name":"Department of Dermatology, CHU Rouen and INSERM U1234, Normandie University, Rouen, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Prost-Squarcioni","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Centre de r\u00e9f\u00e9rence des maladies bulleuses auto-immunes, Avicenne Hospital, Assistance Publique-H\u00f4pitaux de Paris, University of Paris 13, Bobigny, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Labeille","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University of Saint-\u00c9tienne, Saint-\u00c9tienne, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Picard-Dahan","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Bichat Hospital, University of Paris 10, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillaume","family":"Chaby","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University of Amiens, Amiens, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie-Aleth","family":"Richard","sequence":"additional","affiliation":[{"name":"CEReSS-EA 3279, Research Centre in Health Services and Quality of Life Aix Marseille University, Dermatology Department, Universitaire Hospital Timone, Assistance Publique H\u00f4pitaux de Marseille, APHM, 13385, Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuelle","family":"Tancrede-Bohin","sequence":"additional","affiliation":[{"name":"Department of Dermatology, St Louis Hospital, Paris 7 Sorbonne Paris Cit\u00e9 University, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Duvert-Lehembre","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University of Lille, Lille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Delaporte","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University of Lille, Lille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Bernard","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University of Reims, Reims, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fr\u00e9d\u00e9ric","family":"Caux","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Centre de r\u00e9f\u00e9rence des maladies bulleuses auto-immunes, Avicenne Hospital, Assistance Publique-H\u00f4pitaux de Paris, University of Paris 13, Bobigny, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Alexandre","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Centre de r\u00e9f\u00e9rence des maladies bulleuses auto-immunes, Avicenne Hospital, Assistance Publique-H\u00f4pitaux de Paris, University of Paris 13, Bobigny, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Musette","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Centre de r\u00e9f\u00e9rence des maladies bulleuses auto-immunes, Avicenne Hospital, Assistance Publique-H\u00f4pitaux de Paris, 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