To evaluate the efficacy and safety of rituximab in pemphigus foliaceus (PF) focusing on clinical remission rates, relapse rates, and severe adverse events.
Approach:
Study Design: Systematic review and meta-analysis registered on PROSPERO, adhering to PRISMA guidelines.
Eligibility Criteria: Included studies with at least three PF patients treated with rituximab, published in English.
Data Extraction: Data on patient demographics, disease severity, treatment regimens, clinical status, relapses, and adverse events were extracted.
Statistical Analysis: Meta-analysis of proportions was performed using RStudio, with pooled estimates and confidence intervals calculated.
Key Findings:
Rituximab demonstrated a pooled complete remission rate of 75.0% over a median follow-up of 24.5 months.
The median time to complete remission was 9 months.
The pooled relapse rate was 38.0%, occurring at a median of 12.5 months post-infusion.
No significant difference in complete remission rates was observed between lymphoma- and rheumatoid arthritis-type regimens (p = 0.80).
20 severe adverse events were reported among 78 patients, primarily infections (65%).
Interpretation:
Limitations:
Limited number of studies specifically addressing rituximab in PF.
Potential bias due to the predominance of retrospective studies.
