What is your approach to tapering off rituximab in a patient with pemphigus who seems to be remission?

When evaluating a patient in clinical remission, I think the decision to taper should be weighed in light of multiple variables, including the patient’s duration and severity of disease prior to remission, extent of previously failed therapies, tolerability of rituximab, and anti-desmoglein antibody...

When a patient has achieved clinical remission and also has low-titer antibodies to desmoglein 1 and 3 (with the exception of patients who may have non-pathogenic antibodies, which can be trended over time), we discuss tapering rituximab. There are, of course, pemphigus patients, especially those wi...