Intravenous low-dose cyclophosphamide pulses followed by rituximab for ocular mucous membrane pemphigoid

Cyclophosphamide (CyP) is the immunosuppressive agent of choice in ocular mucous membrane pemphigoid (MMP). However, guidelines do not specify the regimen modality of CyP treatment. We introduce our practical management protocol for ocular MMP using fixed low-dose intravenous (IV) pulses of CyP followed by IV rituximab, accompanied by case studies of two elderly patients who achieved complete and enduring remissions without adverse effects.