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The FDA ( U.S. Food and Drug Administration ) has approved Rituxan ( Rituximab ) for the treatment of adults with moderate to severe pemphigus vulgaris, a rare, serious, potentially life-threatening condition characterized by progressive painful blistering of the skin and mucous membranes.

Rituxan is the first biologic therapy approved by the FDA for pemphigus vulgaris and the first major advancement in the treatment of the disease in more than 60 years.

The FDA previously granted Priority Review, Breakthrough Therapy Designation and Orphan Drug Designation to Rituxan for the treatment of pemphigus vulgaris.

The FDA approval is based on data from the RITUX 3, a randomized, controlled trial conducted in France.
The study has compared the RITUX 3 regimen ( EU-approved Rituximab product plus short-term corticosteroids [ CS ] ) to CS alone as a first-line treatment in patients with newly diagnosed moderate to severe pemphigus.

The primary endpoint of the study was complete remission at month 24 without the use of steroids for two or more months.
Results of the study showed that 90% of patients with pemphigus vulgaris treated with the RITUX 3 regimen met the endpoint, compared to 28% of patients with pemphigus vulgaris treated with CS alone.
These results supported the efficacy of Rituxan in treating patients with moderate to severe pemphigus vulgaris, while tapering off of CS therapy.

Recently an international Panel of Experts, the International Bullous Disease Consensus Group, has provided new recommendations on the diagnosis and management of pemphigus in the Journal of the American Academy of Dermatology.
Based on existing European treatment guidelines, a Delphi survey process was used to help achieve international expert consensus.
The consensus includes the recommendation to use an anti-CD20 monoclonal antibody ( Rituximab ) and corticosteroids as first line therapy options for moderate to severe pemphigus.

Pemphigus vulgaris accounts for up to 80% of cases of pemphigus, a group of autoimmune disorders which affect 30,000 to 40,000 people in the United States. ( Xagena )

Source: Genentech, 2018

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