A 40-year-old man with refractory pemphigus vulgaris receives rituximab at a dose of 375 mg/m2 weekly for 4 weeks. The earliest expected clinical improvement occurs after approximately how many weeks?
- A 1 to 2 weeks
- B 12 to 16 weeks
- C 4 to 6 weeks ✓
- D 6 to 12 months
Correct answer: C. 4 to 6 weeks
Explanation
After rituximab therapy for pemphigus, C-cell depletion occurs rapidly, but clinical improvement typically begins around 4 to 6 weeks as existing autoantibodies are cleared. C-cell repopulation often occurs by 6 to 12 months, sometimes with relapse. The 375 mg/m2 weekly x 4 protocol is one standard regimen used in pemphigus, though the lymphoma protocol (same dosing) and rheumatoid arthritis protocol (1000 mg x 2) are both used.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.