{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T20:22:17Z","timestamp":1787775737203,"version":"build-2784847793"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2025,4,21]],"date-time":"2025-04-21T00:00:00Z","timestamp":1745193600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,7]]},"abstract":"Abstract<\/jats:title>\n \n Background:<\/jats:title>\n Rituximab (RTX) is considered the first-line treatment for pemphigus vulgaris (PV), a B-cell-mediated autoimmune bullous disease. However, no clear consensus on the optimum dosage has been achieved yet.<\/jats:p>\n <\/jats:sec>\n \n Objectives:<\/jats:title>\n To compare the clinical efficiency and cost-effectiveness of a low-dose (RTX 2\u00d7500mg) vs conventional (RTX 2\u00d71g) RTX regimen.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods:<\/jats:title>\n \n It is a retrospective study of PV patients who received two doses of RTX during the study period of January 2021 to December 2022 at a tertiary care hospital in South India. The study population was divided into Group A (low-dose RTX 2\u00d7500 mg) and Group B (conventional dose RTX 2\u00d71g). Clinical response was assessed according to Murrell\n et al<\/jats:italic>\n . response criteria, at 6 and 9 months, as RTX-induced B cell depletion is expected to last till 6 to 9 months.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n A total of 57 patients with PV were enrolled in this study (43 in Group A and 14 in Group B). At the end of 6 months, 97.5% achieved remission in Group A and 100% of patients in Group B. At the end of 9 months, 91.66% of patients remained in remission in Group A, whereas all patients maintained remission in Group B. At the end of the 6 months and 9 months, one (2.5%) and three (8.3%) patients had relapse in Group A, whereas in Group B there were no relapses till the completion of 9 months follow-up period. The difference in clinical outcome and relapse rate at the end of the 6 and 9 months was not statistically significant in the two groups of patients.<\/jats:p>\n <\/jats:sec>\n \n Limitations:<\/jats:title>\n Retrospective study with limited sample size; serological assay and immunological assay were not performed.<\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n This study indicated that low-dose RTX is equally efficacious, safe, and cost-effective compared to conventional regimens, over a 9-month study period.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/idoj.idoj_534_24","type":"journal-article","created":{"date-parts":[[2025,4,25]],"date-time":"2025-04-25T03:00:19Z","timestamp":1745550019000},"page":"551-556","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Low Dose Vs Conventional Rituximab Regimen in Pemphigus Vulgaris \u2013 A Retrospective Single Centre Comparative Analysis to Assess the Clinical Efficacy and Cost-Effectiveness"],"prefix":"10.4103","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-2784-4620","authenticated-orcid":false,"given":"Amuthavalli","family":"Kanagarajan","sequence":"first","affiliation":[{"name":"Department of Dermatology, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reena","family":"Rai","sequence":"additional","affiliation":[{"name":"Department of Dermatology, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shanmugasekar","family":"Chandrasekaran","sequence":"additional","affiliation":[{"name":"Department of Dermatology, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahadevan","family":"Krishnaswamy","sequence":"additional","affiliation":[{"name":"Department of Dermatology, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bharathi","family":"Sivakumar","sequence":"additional","affiliation":[{"name":"Department of Dermatology, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,4,21]]},"reference":[{"key":"R1-20250703","doi-asserted-by":"crossref","first-page":"671","DOI":"10.4103\/0378-6323.102354","article-title":"Rituximab in pemphigus","volume":"78","author":"Kanwar","year":"2012","journal-title":"Indian J Dermatol Venereol Leprol"},{"key":"R2-20250703","doi-asserted-by":"crossref","first-page":"163","DOI":"10.3389\/fonc.2018.00163","article-title":"Past, present, and future of rituximab world's first oncology monoclonal antibody therapy","volume":"8","author":"Pierpont","year":"2018","journal-title":"Front Oncol"},{"key":"R3-20250703","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1080\/14712598.2020.1727440","article-title":"Ultra-low dose rituximab for refractory pemphigus vulgaris:A pilot study","volume":"20","author":"Russo","year":"2020","journal-title":"Expert Opin Biol Ther"},{"key":"R4-20250703","doi-asserted-by":"crossref","first-page":"1508","DOI":"10.1111\/ced.15213","article-title":"Comparison of the efficacy and cost-effectiveness of an immunologically targeted low-dose rituximab protocol with the conventional rheumatoid arthritis protocol in severe pemphigus","volume":"47","author":"Singh","year":"2022","journal-title":"Clin Exp Dermatol"},{"key":"R5-20250703","doi-asserted-by":"crossref","first-page":"93","DOI":"10.36253\/ijae-13919","article-title":"Case series of two different dose regimen rituximab therapy for severe pemphigus","volume":"126","author":"Giuliani","year":"2022","journal-title":"Ital J Anat Embryol"},{"key":"R6-20250703","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1016\/j.jaad.2008.01.012","article-title":"Consensus statement on definitions of disease, endpoints, and therapeutic response for pemphigus","volume":"58","author":"Murrell","year":"2008","journal-title":"J Am Acad Dermatol"},{"key":"R8-20250703","doi-asserted-by":"crossref","first-page":"620","DOI":"10.1111\/j.1365-2133.2005.06651.x","article-title":"Anti-CD20 monoclonal antibody (rituximab) in the treatment of pemphigus","volume":"153","author":"Arin","year":"2005","journal-title":"Br J Dermatol"},{"key":"R9-20250703","first-page":"671","article-title":"Follow-up data of rituximab as adjuvant therapy in pemphigus","volume":"62","author":"Khopkar","year":"2017","journal-title":"Indian J Dermatol"},{"key":"R10-20250703","doi-asserted-by":"crossref","first-page":"e14349","DOI":"10.1111\/dth.14349","article-title":"A randomized study comparing full dose and half dose of rituximab in relapsing pemphigus patients","volume":"33","author":"Saleh","year":"2020","journal-title":"Dermatol Ther"},{"key":"R11-20250703","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1007\/s13555-012-0017-3","article-title":"Rituximab in the treatment of pemphigus vulgaris","volume":"2","author":"Zakka","year":"2012","journal-title":"Dermatol Ther (Heidelb)"},{"key":"R12-20250703","doi-asserted-by":"crossref","first-page":"1341","DOI":"10.1111\/bjd.12972","article-title":"Clinical and immunological outcomes of high- and low-dose rituximab treatments in patients with pemphigus:A randomized, comparative, observer-blinded study","volume":"170","author":"Kanwar","year":"2014","journal-title":"Br J 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of low-dose rituximab in the treatment of pemphigus vulgaris:a cohort study","volume":"35","author":"Zhou","year":"2024","journal-title":"J Dermatolog Treat"}],"container-title":["Indian Dermatology Online 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