{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T15:01:30Z","timestamp":1789052490408,"version":"build-2803163510"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T00:00:00Z","timestamp":1742256000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100001411","name":"Indian Council of Medical Research","doi-asserted-by":"publisher","award":["61\/11\/2020-IMM\/BMS"],"award-info":[{"award-number":["61\/11\/2020-IMM\/BMS"]}],"id":[{"id":"10.13039\/501100001411","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,22]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Rituximab (Rtx) and dexamethasone pulse (DP) are the two most commonly used therapeutic regimens in pemphigus vulgaris (PV).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To compare the clinical efficacy, side-effect profile, cost-effectiveness and changes in desmoglein (Dsg) levels in patients with PV treated with an Rtx biosimilar or DP.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This open-label prospective randomized controlled study (trial registration number CTRI\/2020\/04\/032978) was conducted at the All India Institute for Medical Sciences in New Delhi, India, from November 2018 to September 2023. Fifty patients with active PV were randomized into two groups: an Rtx group and a DP group. Patients in both groups also received oral prednisolone in a tapering regimen with azathioprine or mycophenolate mofetil. Follow-up was conducted monthly until remission, then quarterly for at least a year or until relapse. Primary outcomes were remission rates and time to remission; secondary outcomes included relapse rates, adverse events and analysis of cost-effectiveness. Serum anti-Dsg titres were measured at baseline, remission and relapse.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Disease control was achieved within a median of 1\u2005month in 96% of patients in both groups. Remission rates were 92% in the Rtx group and 84% in the DP group, with a similar median time to remission of 3\u2005months. Relapse after attaining remission occurred twice as frequently in the DP group (76% vs. 39%) after a median of 10.5\u2005months. Serum anti-Dsg1 and anti-Dsg3 declined significantly at remission and rose again at relapse. Adverse events, including gastrointestinal and general disorders, were more common in the DP group. Cost analysis revealed Rtx was 20% more cost-effective than DP.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>While both regimens were equally effective in inducing remission in patients with PV, Rtx offered superior long-term disease control, fewer relapses and adverse events, and greater cost-effectiveness.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ced\/llaf118","type":"journal-article","created":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T13:09:21Z","timestamp":1742303361000},"page":"1766-1776","source":"Crossref","is-referenced-by-count":2,"title":["Comparison of clinical efficacy and cost-effectiveness of rituximab infusion and intravenous dexamethasone pulse therapy in pemphigus vulgaris: an open prospective randomized controlled pilot study"],"prefix":"10.1093","volume":"50","author":[{"given":"Preeti","family":"Sharma","sequence":"first","affiliation":[{"name":"Department of Dermatology and Venereology, All India Institute of Medical Sciences (AIIMS) , New Delhi ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rhea","family":"Ahuja","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology, All India Institute of Medical Sciences (AIIMS) , New Delhi ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alpana","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Biochemistry , AIIMS, New Delhi ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sudheer","family":"Arava","sequence":"additional","affiliation":[{"name":"Department of Pathology , AIIMS, New Delhi ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pooja","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Pharmacology AIIMS , New Delhi ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kapil","family":"Yadav","sequence":"additional","affiliation":[{"name":"Centre for Community Medicine , AIIMS, New Delhi ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashish Datt","family":"Upadhyay","sequence":"additional","affiliation":[{"name":"Department of Biostatistics , AIIMS, New Delhi ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sujay","family":"Khandpur","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology, All India Institute of Medical Sciences (AIIMS) , New Delhi ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,3,18]]},"reference":[{"key":"2025082212464954700_llaf118-B1","doi-asserted-by":"crossref","first-page":"875","DOI":"10.1111\/j.1365-4362.1995.tb04430.x","article-title":"Dexamethasone-cyclophosphamide pulse therapy for pemphigus","volume":"34","author":"Pasricha","year":"1995","journal-title":"Int J Dermatol"},{"key":"2025082212464954700_llaf118-B2","doi-asserted-by":"crossref","first-page":"1900","DOI":"10.1111\/jdv.16752","article-title":"Updated S2\u2005K guidelines on the management of pemphigus vulgaris and foliaceus initiated by the european academy of dermatology and venereology (EADV)","volume":"34","author":"Joly","year":"2020","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"2025082212464954700_llaf118-B3","doi-asserted-by":"crossref","first-page":"2031","DOI":"10.1016\/S0140-6736(17)30070-3","article-title":"First-line rituximab combined with short-term prednisone versus prednisone alone for the treatment of pemphigus (Ritux 3): a prospective, multicenter, parallel-group, open-label randomised trial","volume":"389","author":"Joly","year":"2017","journal-title":"Lancet"},{"key":"2025082212464954700_llaf118-B4","doi-asserted-by":"crossref","first-page":"1377","DOI":"10.1111\/j.1468-3083.2011.04294.x","article-title":"Utility of desmoglein ELISA in the clinical correlation and disease monitoring of pemphigus vulgaris","volume":"26","author":"Anand","year":"2012","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"2025082212464954700_llaf118-B5","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1001\/jamadermatol.2020.0290","article-title":"Factors associated with short-term relapse in patients with pemphigus who receive rituximab as first-line therapy: a post hoc analysis of a randomized clinical trial","volume":"156","author":"Mignard","year":"2020","journal-title":"JAMA 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