How do you counsel patients with pemhigus on the main safety benefits of a low or ultra low dose rituximab regimen?

Although I read this article with interest and an open mind, I have not adopted ultra-low dose rituximab into my clinical practice of treating pemphigus patients for several reasons. The author's conclusions may very well end up being correct over time, but there are too many concerns with the study design to warrant changing my clinical practice at this time.

For pemphigus patients, I dose patients with rituximab 1000 mg x 2 spread 2 weeks apart per the rheumatoid arthritis protocol, every 6 mon...

I don’t think there is a documented big difference in safety to use low-dose rituximab. It is more likely that the pathogenic B cells will come back quicker with low-dose rituximab, with higher relapse rates that require retreatment sooner with rituximab.