{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T14:29:22Z","timestamp":1788791362531,"version":"build-2803163510"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"Abstract<\/jats:title>\n \n Background:<\/jats:title>\n Rituximab has changed the paradigm for management of pemphigus vulgaris (PV). Despite its widespread use, variability exists in its use, particularly related to dosing protocols, prophylaxis, and use in special populations. This study aimed to assess dermatologists\u2019 knowledge, attitude, and practices regarding rituximab in India.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods:<\/jats:title>\n A cross-sectional questionnaire-based survey was conducted among Indian dermatologists with at least six months of clinical experience post-residency between March and June 2024. An 85-question survey was used to gather information on knowledge, attitudes, and practices related to rituximab. Descriptive statistics were employed to analyze the data and identify practice variations.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Fifty-five dermatologists with a mean practice experience of 13 years participated. Most (78.2%) preferred rituximab as first-line adjuvant for PV, citing higher remission rates and fewer long-term adverse effects. Knowledge of rituximab\u2019s mechanism of action was excellent. However, significant practice variability was observed. The standard dose rheumatoid arthritis protocol for moderate-to-severe disease was preferred by 69.1%, whereas only 14.5% strongly supported low-dose regimens. Screening for latent tuberculosis was commonly performed (80%). Prophylaxis for\n Pneumocystis jirovecii<\/jats:italic>\n pneumonia and vaccination practices were inconsistent, with only 12.7% always prescribing prophylaxis. Additionally, 61.8% used rituximab retreatment on clinical relapse, with less emphasis on immunological markers for monitoring.\n <\/jats:p>\n <\/jats:sec>\n \n Limitations:<\/jats:title>\n The responses may not be representative of all dermatologists, especially those with less experience with rituximab.<\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n While dermatologists demonstrated strong knowledge of rituximab, significant variability in dosing, prophylaxis, and retreatment practices exists. Standardized guidelines and educational initiatives may be needed to ensure consistent use of rituximab and improve patient outcomes.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/idoj.idoj_631_25","type":"journal-article","created":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T14:00:09Z","timestamp":1788789609000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Knowledge, Attitude, and Practice of Use of Rituximab in Pemphigus among Indian Dermatologists: A Cross-Sectional Questionnaire-Based Survey"],"prefix":"10.4103","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8682-2598","authenticated-orcid":false,"given":"Dipankar","family":"De","sequence":"first","affiliation":[{"name":"Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Narayanan","family":"Baskaran","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rahul","family":"Mahajan","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abir","family":"Saraswat","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Indushree Skin Clinic, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepika","family":"Pandhi","sequence":"additional","affiliation":[{"name":"Department of Dermatology and STD, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geeti","family":"Khullar","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Lady Hardinge Medical College, Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kolalapudi Seetharam","family":"Anjaneyulu","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Leprology, GSL Medical College, Rajahmundry, Andhra Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manas","family":"Chatterjee","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Armed Forces Medical Services, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manjunath","family":"Shenoy","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Leprology, Yenepoya Medical College, Mangalore, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Murlidhar","family":"Rajagopalan","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Apollo Hospitals, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nayeem Sadath","family":"Haneef","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Leprology, Deccan College of Medical Sciences, Hyderabad, Telangana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nilay Kanti","family":"Das","sequence":"additional","affiliation":[{"name":"Department of Dermatology, College of Medicine and Sagore Dutta Hospital, Kolkata, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raghavendra","family":"Rao","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Leprology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheetanshu","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Dermatology and STD, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shekhar","family":"Neema","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Armed Forces Medical College, Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shyamanta","family":"Barua","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Assam Medical College and Hospital, Dibrugarh, Assam, 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, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinay","family":"Keshavamurthy","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vishal","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjeev","family":"Handa","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, 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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":"R8-20260907","doi-asserted-by":"crossref","first-page":"3","DOI":"10.4103\/idoj.idoj_1059_24","article-title":"Consensus based Indian guidelines for the management of pemphigus vulgaris and pemphigus foliaceous","volume":"16","author":"De","year":"2024","journal-title":"Indian Dermatol Online J"},{"key":"R9-20260907","doi-asserted-by":"crossref","first-page":"2295","DOI":"10.1056\/NEJMoa2028564","article-title":"Rituximab versus mycophenolate mofetil in patients with pemphigus vulgaris","volume":"384","author":"Werth","year":"2021","journal-title":"N Engl J Med"},{"key":"R10-20260907","doi-asserted-by":"crossref","first-page":"e0198074","DOI":"10.1371\/journal.pone.0198074","article-title":"Comparison of rituximab and conventional adjuvant therapy for pemphigus 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Protocol and single-center experience","volume":"114","author":"Su\u00e1rez-Caranto\u00f1a","year":"2023","journal-title":"Actas Dermosifiliogr"},{"key":"R14-20260907","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1111\/j.1468-3083.2005.01345.x","article-title":"Therapy of paraneoplastic pemphigus with rituximab: A case report and review of literature","volume":"20","author":"Barnadas","year":"2006","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"R15-20260907","doi-asserted-by":"crossref","first-page":"416","DOI":"10.4103\/0019-5154.135513","article-title":"Biosimilars in pemphigus vulgaris","volume":"59","author":"Patil","year":"2014","journal-title":"Indian J Dermatol"},{"key":"R16-20260907","doi-asserted-by":"crossref","first-page":"317","DOI":"10.4103\/ijdvl.IJDVL_1078_14","article-title":"Low-dose rituximab as an adjuvant therapy in pemphigus","volume":"83","author":"Gupta","year":"2017","journal-title":"Indian J Dermatol Venereol 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History"}},{"value":"2025-09-15","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}