Article

Anti-CD20 monoclonal antibody (rituximab) in the treatment of pemphigus.

Department of Dermatology, University of Cologne, 50924 Cologne, Germany.
British Journal of Dermatology (impact factor: 3.67). 10/2005; 153(3):620-5. DOI:10.1111/j.1365-2133.2005.06651.x pp.620-5
Source: PubMed

ABSTRACT Pemphigus is a severe autoimmune blistering disorder caused by autoantibodies to desmoglein 1 and 3. The disease course is typically severe, thus requiring multiple immunosuppressive agents. The treatment is still challenging and in some patients with recalcitrant disease, therapies fail and therapeutic options are limited.
To investigate whether depletion of B lymphocytes that are thought to produce disease-causing autoantibodies shows a long-term benefit in pemphigus.
Five patients diagnosed as having pemphigus vulgaris and pemphigus foliaceus were treated with the monoclonal antibody rituximab. Rituximab was administered intravenously at a dosage of 375 mg m(-2) once weekly for 4 weeks.
The treatment was well tolerated and all patients showed a good response over a follow-up period of up to 3 years, allowing immunosuppressive treatment to be reduced or terminated. B-cell depletion persisted for 6-12 months, and in one patient for almost 3 years.
This study highlights the prolonged effect and disease control after one single course of rituximab and further extends the spectrum of treatments of bullous autoimmune disorders.

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Keywords

3 years
 
B lymphocytes
 
B-cell depletion
 
bullous autoimmune disorders
 
desmoglein 1
 
disease control
 
disease course
 
disease-causing autoantibodies
 
follow-up period
 
immunosuppressive treatment
 
long-term benefit
 
monoclonal antibody rituximab
 
pemphigus
 
pemphigus foliaceus
 
pemphigus vulgaris
 
prolonged effect
 
recalcitrant disease
 
Rituximab
 
severe autoimmune blistering disorder
 
single course
 

M J Arin