Journal Article

A Single Cycle of Rituximab for the Treatment of Severe Pemphigus

Doutre, Marie-Sylvie, Tancrede-Bohin, Emmanuelle, D'Incan, Michel, Mouquet, Hugo, Hertl, Michael, Delaporte, Emmanuel, Bernard, Philippe, Gougeon, Marie-Lise, Jacquot, Serge, Bedane, Christophe, Joly, Pascal, Dreno, Brigitte, Tron, François, Franck, Nathalie, Picard, Catherine, Muller, Ralf, Roujeau, Jean-Claude, Pauwels, Christine, Musette, Philippe, Caux, Frédéric, Gilbert, Danièle

2007

Overview

In this study of 21 patients with severe pemphigus whose disease was refractory to or dependent on systemic corticosteroids or who had contraindications to corticosteroids, 18 patients (86%) had a complete remission after a single cycle of rituximab treatment. Two patients had serious infections, one of which resulted in death. The efficacy of rituximab for pemphigus must be weighed against the risk of severe adverse events. In this study of 21 patients with severe pemphigus, 18 patients (86%) had a complete remission after a single cycle of rituximab treatment. The efficacy of rituximab must be weighed against the risk of severe adverse events. Pemphigus is a life-threatening autoimmune blistering disease affecting the skin and mucosa. It is mediated by pathogenic autoantibodies directed against desmoglein 1 and desmoglein 3, adhesion molecules of the epidermis that are responsible for the cohesion between keratinocytes in skin and mucosa, respectively. 1 – 3 Patients with severe pemphigus require long-term treatment with corticosteroids and other immunosuppressive drugs, which can lead to serious adverse events. 4 , 5 Rituximab, a monoclonal antibody directed against the CD20 antigen of B lymphocytes, has been demonstrated to be effective in various autoimmune diseases 6 – 12 and in occasional cases of life-threatening pemphigus. 13 – 22 Recently, the combination of . . .

• Publisher: Massachusetts Medical Society
• Subject: Aged / Anti-Inflammatory Agents - administration & dosage / Antibodies - blood / Antibodies, Monoclonal - administration & dosage / Antibodies, Monoclonal, Murine-Derived / Autoimmune diseases / B-Lymphocytes / Clinical trials / Desmogleins - immunology / Drug Administration Schedule / Drug therapy / Drug Therapy, Combination / Female / Follow-Up Studies / Humans / Immunoglobulin Isotypes - blood / Immunologic Factors - administration & dosage / Infusions, Intravenous / Male / Middle Aged / Mucous membrane / Pemphigus - drug therapy / Pemphigus - immunology / Prednisone - administration & dosage / Remission Induction / Rituximab / Skin diseases