Michael Kasperkiewicz1, Iakov Shimanovich2, Ralf J Ludwig2, Christian Rose2, Detlef Zillikens2, Enno Schmidt3. 1. Department of Dermatology, University of Lübeck, Lübeck, Germany. Electronic address: Michael.Kasperkiewicz@uk-sh.de. 2. Department of Dermatology, University of Lübeck, Lübeck, Germany. 3. Department of Dermatology, University of Lübeck, Lübeck, Germany; Comprehensive Center for Inflammatory Medicine, University of Lübeck, Lübeck, Germany.
Abstract
BACKGROUND: Rituximab has been increasingly used in autoimmune blistering dermatoses, mainly in pemphigus. However, only a few larger case series are available on this subject and information on the efficacy of retreatment with rituximab during relapses is lacking. OBJECTIVE: We sought to determine efficacy and adverse effects of adjuvant rituximab. METHODS: Seventeen patients with refractory autoimmune blistering dermatoses (pemphigus vulgaris [PV], n = 8; pemphigus foliaceus [PF], n = 2; bullous pemphigoid [BP], n = 2; mucous membrane pemphigoid, n = 5) were treated 4 times with rituximab at an individual dose of 375 mg/m(2) in weekly intervals or twice with 1000 mg 2 weeks apart. Six of 8 patients with a relapse after this regimen received rituximab again twice with 1000 mg in a 2-week interval. RESULTS: All lesions cleared in 14 patients (7 PV, two PF, two BP, 3 mucous membrane pemphigoid), whereas partial healing was found in 3 others (one PV, two mucous membrane pemphigoid). Relapses occurred in 8 patients (5 PV, two PF, one BP). Retreatment with rituximab again resulted in complete (two PV, one PF, one BP) or partial (two PV) remission. Serious side effects associated with rituximab were not observed. LIMITATIONS: Rituximab has been combined with various other immunosuppressive or immunomodulatory treatments. CONCLUSION: Adjuvant rituximab is effective and well tolerated not only in patients with pemphigus but also with pemphigoid. Efficacy and safety of rituximab are maintained when it is readministered during relapses.
BACKGROUND:Rituximab has been increasingly used in autoimmune blistering dermatoses, mainly in pemphigus. However, only a few larger case series are available on this subject and information on the efficacy of retreatment with rituximab during relapses is lacking. OBJECTIVE: We sought to determine efficacy and adverse effects of adjuvant rituximab. METHODS: Seventeen patients with refractory autoimmune blistering dermatoses (pemphigus vulgaris [PV], n = 8; pemphigus foliaceus [PF], n = 2; bullous pemphigoid [BP], n = 2; mucous membrane pemphigoid, n = 5) were treated 4 times with rituximab at an individual dose of 375 mg/m(2) in weekly intervals or twice with 1000 mg 2 weeks apart. Six of 8 patients with a relapse after this regimen received rituximab again twice with 1000 mg in a 2-week interval. RESULTS: All lesions cleared in 14 patients (7 PV, two PF, two BP, 3 mucous membrane pemphigoid), whereas partial healing was found in 3 others (one PV, two mucous membrane pemphigoid). Relapses occurred in 8 patients (5 PV, two PF, one BP). Retreatment with rituximab again resulted in complete (two PV, one PF, one BP) or partial (two PV) remission. Serious side effects associated with rituximab were not observed. LIMITATIONS: Rituximab has been combined with various other immunosuppressive or immunomodulatory treatments. CONCLUSION: Adjuvant rituximab is effective and well tolerated not only in patients with pemphigus but also with pemphigoid. Efficacy and safety of rituximab are maintained when it is readministered during relapses.
Authors: Luisa Lunardon; Kathleen J Tsai; Kathleen J Propert; Nicole Fett; John R Stanley; Victoria P Werth; Donald E Tsai; Aimee S Payne Journal: Arch Dermatol Date: 2012-09
Authors: F Proft; H Schulze-Koops; M Grunke; E Schrezenmeier; F Halleck; J Henes; L Unger; E Schmidt; C Fiehn; A Jacobi; C Iking-Konert; C Kneitz; R E Schmidt; B Bannert; R E Voll; R Fischer-Betz; I Kötter; H P Tony; J Holle; M Aringer; A Erler; F Behrens; G R Burmester; T Dörner Journal: Z Rheumatol Date: 2018-02 Impact factor: 1.372