A prospective study on clinical response and cell-mediated immunity of pemphigus patients treated with rituximab

Leshem, Y. A.; David, Michael; Hodak, Emmilia; Waitman, Dan‐Andrei; Vardy, Daniel; Israeli, Moshe; Eskin‐Schwartz, Marina; Bergman, Reuven; Mimouni, Daniel

doi:10.1007/s00403-013-1355-4

Cited by 25 publications

(20 citation statements)

References 35 publications

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“…After 3 months of treatment with dapsone as an adjuvant, the prednisone daily dose range was 0-40 mg/day (mean: 11 ± 8 mg/day), and at the last follow-up it was 0-40 mg/day (mean: 12 ± 12 mg/day). This reduction in the daily dose of prednisone is statistically signifi- 2 The mean Hb reduction in the study group was 1.3 mg/dl. 3 Three patients did not complete due to treatment failure (as defined by the consensus statement) after 3 months but before 6 months, 2 due to remission at 4 months, and 1 due to adverse effects at 4 months (headaches).…”

Section: Resultsmentioning

confidence: 74%

Efficacy of Dapsone in the Treatment of Pemphigus Vulgaris: A Single-Center Case Study

Baum¹,

Debby²,

Gilboa³

et al. 2016

Dermatology

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Background: Pemphigus vulgaris (PV) is a chronic autoimmune blistering disease. Most patients require long-term therapy with systemic steroids, and a steroid-sparing agent is usually also utilized. Dapsone is a chemotherapeutic agent with anti-inflammatory properties that is used as a steroid-sparing agent in PV. Objective: The aim of the present study was to evaluate the efficacy of dapsone as an adjuvant therapy in patients with PV. Methods: A retrospective analysis of patients' files was performed. All 26 patients included in the study group were treated with dapsone as an adjuvant to systemic steroids for at least 3 consecutive months and were followed up during their dapsone treatment period. Results: After 3 months of treatment with dapsone, 13 patients were in the consolidation phase, 4 patients demonstrated partial remission on minimal therapy, 7 patients demonstrated complete remission on minimal therapy, and 2 patients were defined as treatment failures. The trend of clinical improvement continued after 6 months of treatment and at the study end point. Conclusion: This retrospective case series, one of the largest reported, indicates that dapsone is efficacious and safe for patients with PV in whom it is well tolerated soon after the initiation of treatment.

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Section: Resultsmentioning

confidence: 74%

Efficacy of Dapsone in the Treatment of Pemphigus Vulgaris: A Single-Center Case Study

Baum¹,

Debby²,

Gilboa³

et al. 2016

Dermatology

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“…At 6 months of dosage treatment 90% of patients achieved remission. At 22 months there was a 67% relapse rate with patients, however Global CD 4 + T cell numbers were preserved up to 3 months after treatment [114]. In conjunction with corticosteroids and other cytotoxic agents, Rituximab has also been used to treat SLE and other Ab mediated autoimmune diseases [115,116].…”

Section: Rituximab and B Cell Depletion Therapymentioning

confidence: 97%

B cell epitope spreading: Mechanisms and contribution to autoimmune diseases

Cornaby¹,

Gibbons²,

Mayhew³

et al. 2015

Immunology Letters

147

108

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“…In addition to its benefits on B cell blockade and clinical improvement, recent studies have demonstrated that rituximab also has an effect on autoaggressive and regulatory T cells, making it an even more promising candidate for the treatment of PV [27][28][29]. One seminal study proposing this theory looked at 11 patients treated with rituximab and measured the frequency of CD4+ T helper (Th) cells at 0, 1, 3, 6 & 12 months after therapy [27].…”

Section: B Cell Blockadementioning

confidence: 99%

Pemphigus vulgaris: approach to treatment

Sinha¹,

Hoffman²,

Janicke³

2015

European Journal of Dermatology

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The therapeutic management of pemphigus vulgaris (PV) is centered around immunosuppression, which can be generalized, as in the use of corticosteroids or steroid sparing agents, or specific, as in therapeutic blockage of autoantibody production, certain cytokines, or signaling pathways. Currently, the backbone of treatment for PV, particularly, first line therapy, remains systemic corticosteroids. Although very effective, the significant side effects of long-term corticosteroid usage are well documented. Adjunctive therapies aim to eliminate, or at least decrease, the necessary dose of corticosteroids. Specifically, azathioprine, cyclophosphamide, methotrexate, cyclosporine, mycophenolate mofetil and dapsone are now widely used in PV. Intravenous immunoglobulin (IVIG), plasmapheresis, immunoadsorption, and most recently, rituximab, are other members of the therapeutic armamentarium. However, despite the widening range of treatment options in PV, well-controlled clinical trials and consensus guidelines are lacking.

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A prospective study on clinical response and cell-mediated immunity of pemphigus patients treated with rituximab

Cited by 25 publications

References 35 publications

Efficacy of Dapsone in the Treatment of Pemphigus Vulgaris: A Single-Center Case Study

Efficacy of Dapsone in the Treatment of Pemphigus Vulgaris: A Single-Center Case Study

B cell epitope spreading: Mechanisms and contribution to autoimmune diseases

Pemphigus vulgaris: approach to treatment

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