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The following is a summary of “Rituximab combined with intravenous immunoglobulin in autoimmune diseases: a systematic review,” published in the March 2025 issue of Advances in Rheumatology by Carvalho & Skare. 

Rituximab (RTX) and intravenous immunoglobulin (IVIg) are established treatments for autoimmune diseases. Their combined use is rare and understudied. 

Researchers conducted a retrospective study on RTX with IVIg in autoimmune diseases. 

They screened PubMed/MEDLINE, EMBASE, and Scielo for articles on RTX plus IVIg in autoimmune diseases until May 2024. 

The results showed that 21 studies evaluated RTX plus IVIg for autoimmune diseases. About 10 studies on pemphigus included 85 patients (47 pemphigus vulgaris, 27 pemphigoids, 11 other variants). Most were case reports or series, with 1 retrospective study including controls. Positive outcomes were seen in all but 1 paraneoplastic pemphigus case. Infections, including P. jirovecii pneumonia, were reported in 3 studies. The other 11 studies included 24 patients with polyneuropathies, CNS lupus, and neuromyelitis optica. Most showed favorable outcomes, but 1 trial found RTX ineffective in reducing IVIg needs. Adverse events included pneumonia, venous thrombosis with pulmonary embolism, and infusion reactions. 

Investigators found RTX plus IVIg to be a potential option for refractory autoimmune diseases but noted the need for larger studies in diverse conditions.

Source: advancesinrheumatology.biomedcentral.com/articles/10.1186/s42358-025-00450-x