NCT03790293

Brief Summary

Pemphigus is an autoimmune disease specific to the skin and mucous membranes characterized by the production of IgG4 isotype autoantibodies (AC) directed mainly against two proteins involved in interkeratinocyte adhesion: desmoglein 1 (Dsg1 ) and desmoglein 3 (Dsg3) (1-3). The binding of auto-AC on these proteins disrupts their adhesion function, resulting in inter-keratinocyte dysjunction called "acantholysis" responsible for the formation of intraepidermal bubbles. Treatment of pemphigus is typically based on systemic corticosteroids. High doses are usually necessary because of the frequent cortico-resistance of the disease. In recent years, several studies have focused on the treatment of pemphigus with anti-CD20: rituximab. The "Ritux 3" study (NCT00784589), a randomized, multicentre, randomized, non-blind clinical trial involving 90 patients, found that the use of rituximab as first-line therapy in combination with short corticosteroid therapy was extremely effective and that cortisone sparing was thus obtained limited the occurrence of side effects of treatment. On the other hand, this study showed that the 2 rituximab maintenance infusions of 500 mg to M12 and M18 allowed the maintenance of a high rate of complete remission up to the 3rd year of follow-up. Questions remain to explain the long-term action of rituximab, in particular that of the evolution of these auto-reactive B cells (specific DSG) away from lymphocyte reconstitution B, as well as the evolution of auto-AC. anti-DSG and total IgG CAs, so as to ensure that the disappearance of the auto-reactive compartment is not accompanied by a long-term overall immunosuppression (and therefore a possible risk of infection). The immunological changes induced in the long term as well as the precise mechanism of action of these treatments and particularly rituximab which allows a complete remission 5 years after treatment in many patients remain little known.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
80

participants targeted

Target at below P25 for phase_3

Timeline
Completed

Started Nov 2018

Shorter than P25 for phase_3

Geographic Reach
1 country

25 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

October 8, 2018

Completed
1 month until next milestone

Study Start

First participant enrolled

November 17, 2018

Completed
1 month until next milestone

First Posted

Study publicly available on registry

December 31, 2018

Completed
4 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

April 19, 2019

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

April 19, 2019

Completed
Last Updated

February 6, 2026

Status Verified

February 1, 2026

Enrollment Period

5 months

First QC Date

October 8, 2018

Last Update Submit

February 4, 2026

Conditions

Outcome Measures

Primary Outcomes (2)

  • Evaluate the occurrence of long-term serious AEs and AEs in patients initially randomized in the rituximab arm and in those who have secondarily received the product during the course of their pemphigus

    Collect of SAE and AE

    1 day: 5 to 7 years after the inclusion into RITUXIMAB 3 study

  • Evaluate the long-term relapse rate in patients initially randomized in the rituximab arm and in those who have secondarily received the product during the course of their pemphigus

    Collect of relapses

    1 day: 5 to 7 years after the inclusion into RITUXIMAB 3 study

Study Arms (2)

Rituximab

EXPERIMENTAL

Rituximab in combination with reduced corticosteroids is administrated

Drug: RituximabDrug: corticosteroids'therapy

Standard corticosteroid

ACTIVE COMPARATOR

Standard corticosteroid is administrated

Drug: corticosteroids'therapy

Interventions

Patient was enrolled into the RITUXIMAB 3 study in the arm Rituximab in association with low corticosteroids'therapy

Rituximab

Patient was enrolled into the RITUXIMAB 3 study in the arm Patient was enrolled into the RITUXIMAB 3 study in the arm standard corticosteroid

RituximabStandard corticosteroid

Eligibility Criteria

Age18 Years - 80 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Patient included in the RITUXIMAB 3 study
  • Major patient who has read and understood the newsletter and signed the consent form

You may not qualify if:

  • Person deprived of liberty by an administrative or judicial decision
  • Person placed under the safeguard of justice
  • Person under tutorship or curators
  • Pregnant or lactating woman

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (25)

Chu Angers

Angers, 49100, France

Location

Ap-Hp Avicenne

Bobigny, 93000, France

Location

Chu Bordeaux

Bordeaux, 33076, France

Location

Chu Brest

Brest, 29200, France

Location

Chu Clermont-Ferrand

Clermont-Ferrand, 63100, France

Location

Ap-Hp Henri Mondor

Créteil, 94010, France

Location

Chu Dijon

Dijon, 21000, France

Location

Ch Le Mans

Le Mans, 72037, France

Location

Chru Lille

Lille, 59000, France

Location

Chu Limoges

Limoges, 87000, France

Location

Hcl Edouard Herriot

Lyon, 69003, France

Location

Hcl Ch Lyon Sud

Lyon, 69310, France

Location

Ap-Hm La Timone

Marseille, 13385, France

Location

Chu Montpellier

Montpellier, 34090, France

Location

Chu Nantes

Nantes, 44000, France

Location

Ah-Hp Cochin

Paris, 75006, France

Location

Ap-Hp Saint-Louis

Paris, 75010, France

Location

Ap-Hp Cochin

Paris, 75014, France

Location

Ap-Hp Bichat

Paris, 75018, France

Location

Chu Reims

Reims, 51092, France

Location

Chu Rennes

Rennes, 35000, France

Location

Chu Rouen

Rouen, 76031, France

Location

Chu Saint-Etienne

Saint-Etienne, 42270, France

Location

Chu Toulouse

Toulouse, 31059, France

Location

Chu Tours

Tours, 37000, France

Location

MeSH Terms

Conditions

Autoimmune Diseases

Interventions

Rituximab

Condition Hierarchy (Ancestors)

Immune System Diseases

Intervention Hierarchy (Ancestors)

Antibodies, Monoclonal, Murine-DerivedAntibodies, MonoclonalAntibodiesImmunoglobulinsImmunoproteinsBlood ProteinsProteinsAmino Acids, Peptides, and ProteinsSerum GlobulinsGlobulins

Study Design

Study Type
interventional
Phase
phase 3
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Model Details: Patients included and treated in the RITUXIMAB 3 study (NCT00784589): * Rituximab in combination with reduced corticosteroids * Standard corticosteroid
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

October 8, 2018

First Posted

December 31, 2018

Study Start

November 17, 2018

Primary Completion

April 19, 2019

Study Completion

April 19, 2019

Last Updated

February 6, 2026

Record last verified: 2026-02

Locations