Bullous pemphigoid associated with anti‐programmed cell death protein 1 and anti‐programmed cell death ligand 1 therapy: A case series of 13 patients

Abstract

We present a case series of 13 patients, the first Australian single-centre study of bullous pemphigoid (BP) associated with immune checkpoint inhibitors (ICI): cytotoxic T-lymphocyte antigen (CTLA4) and programmed cell death receptor (PD1) inhibitors. All our patients achieved adequate control of BP with a combination of treatments including oral prednisolone, intravenous immunoglobulin, rituximab and omalizumab. The majority of patients ceased or interrupted immunotherapy treatment upon diagnosis of BP and greater tumour progression was seen in the cohort who ceased immunotherapy. K E Y W O R D Sbullous pemphigoid, immune check point inhibitor, immune-related adverse events, immunotherapy How to cite this article: Yun JSW, Chan OB, Goh M, McCormack CJ. Bullous pemphigoid associated with anti-programmed cell death protein 1 and anti-programmed cell death ligand 1 therapy: A case series of 13 patients.

Classification and Antigen Molecules of Autoimmune Bullous Diseases

“…Drug-induced pemphigoid is also known, and has recently attracted particular attention in relation to dipeptidyl peptidase-4 (DPP-4) inhibitors [ 29 ] and immune checkpoint inhibitors [ 30 , 31 ]. The autoantibodies in drug-induced pemphigoid react mainly with BP180 (NC16a domain, LAD-1 and C-terminal domain) and less with BP230 [ 29 , 30 , 31 ].…”

“…Drug-induced pemphigoid is also known, and has recently attracted particular attention in relation to dipeptidyl peptidase-4 (DPP-4) inhibitors [ 29 ] and immune checkpoint inhibitors [ 30 , 31 ]. The autoantibodies in drug-induced pemphigoid react mainly with BP180 (NC16a domain, LAD-1 and C-terminal domain) and less with BP230 [ 29 , 30 , 31 ]. Radiation-induced BP is also known, and appeared mostly after the cessation of radiation treatment, and some of the cases were identified to be positive for autoantibodies against BP180 and BP230 [ 32 , 33 ].…”