Clinical Evaluation and Comparison between Effects of Rituximab and Prednisolone with Imuran to Neutrophils and Platelet Counts in Pemphigus Vulgaris Patients

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AbstractBackground:Pemphigus vulgaris (PV) is an autoimmune vesiculobullous mucocutaneous disease with life-threatening consequences. Rituximab (RTX) has recently emerged as an effective treatment for PV.Objectives:This study aims to determine changes in neutrophil and platelet counts for PV patients treated with RTX or corticosteroids combined with Imuran (azathioprine).Materials and Methods:The present cross-sectional study was conducted in the Department of Dermatology at Baghdad Teaching Hospital, Baghdad, Iraq. Thirty PV patients received two types of treatment: 15 patients were administered RTX and 15 patients took corticosteroids with Imuran (azathioprine). Neutrophil and platelet counts were detected at the hospital laboratory.Results:The age range of PV patients was 27–67 years, and the mean ±SD was 44.866 ± 10.979 years for the patient group treated with RTX and 44.133 ± 11.519 for the patient group treated with corticosteroids and Imuran. In patients treated with RTX, 26.6% were males and 73.33% were females, with a female-to-male ratio of 2.75:1. In patients treated with corticosteroids with Imuran, 40% were males and 60% were females, with a female-to-male ratio of 1.5:1. The results revealed that among patients treated with RTX, 30% of them had mucocutaneous lesions, 6.66% had oral lesions, and 13.33% had cutaneous lesions. Among the other groups treated with corticosteroids and Imuran, 23.33% had mucocutaneous lesions, 13.33% had oral lesions, and 13.33% had cutaneous lesions. Among the patients treated with RTX, 53.33% had normal range of neutrophil count, while 46.6% had neutrophil count above the NR, while in patients treated with corticosteroids and Imuran, 40% had a normal range and 60% had above the normal range.Conclusion:RTX was a more effective treatment compared to corticosteroids with Imuran because no patient remained in an active state during this study. PV was prevalent in females aged 40 years with mucocutaneous lesions.