Research in Brief

Abstract

Rituximab may be superior to mycophenolate mofetil for the treatment of pemphigus vulgaris, according to the results of a randomised trial by Victoria Werth and colleagues. 135 patients with moderate-to-severe pemphigus vulgaris were randomly assigned (1:1) to receive intravenous rituximab (1000 mg on days 1, 15, 168, and 182; n=67) or oral mycophenolate mofetil (2 g daily; n=68), both in addition to tapered oral glucocorticoids. At week 52, sustained complete remission (defined as a Pemphigus Disease Area Index activity score of 0 for at least 16 weeks without the use of glucocorticoids; the primary outcome) was achieved in 25 (40%) of 62 patients in the rituximab group versus six (10%) of 63 in the mycophenolate mofetil group (difference 31%, 95% CI 15–45; p<0·001). 15 (22%) of 67 patients in the rituximab group had an adverse event versus 10 (15%) of 68 in the mycophenolate mofetil group.