Refractory pemphigus vulgaris treated with rituximab and mycophenolate mofetil

Abstract

The main treatment for pemphigus vulgaris are systemic corticosteroids and immunosuppressive agents, but due to adverse reactions and therapeutic failure, new drugs such as rituximab and mycophenolate mofetil have been used. In this case report are described two cases of severe pemphigus vulgaris refractory to various treatments, with resolution after use of rituximab and mycophenolate mofetil, associated with corticosteroids. A higher-than-usual dose of rituximab was employed, without the occurrence of serious adverse reactions. Mycophenolate mofetil was added as adjunctive therapy due to lack of response to azathioprine.

Dexamethasone-cyclophosphamide pulse therapy outcomes comparing pemphigus vulgaris and pemphigus foliaceus groups in a Brazilian cohort study

“…11 In the last years, it has been considered the first-line option to treat pemphigus in developed countries. 1 Nevertheless, in Brazil, Rituximab has been prescribed as an exceptional option, for those cases of unresponsiveness to commoner drugs, 12 , 13 , 14 which encouraged us to look for a diverse treatment in order to decrease corticoid side effects when chronically prescribed. 9 , 10 …”