Rituximab (Anti-CD20 Monoclonal Antibody) – Ultimate or First Choice in Pemphigus?

Hertl, Michael; Eming, Rüdiger; Borradori, Luca

doi:10.1159/000100876

Cited by 14 publications

(10 citation statements)

References 10 publications

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“…Here, a total of 22 patients with refractory PV were treated with rituximab which had been recently identified as a potent treatment in refractory PV [24, 25]. Specifically, these patients did not adequately respond to standard immunosuppressive treatment consisting of high dose systemic corticosteroids combined with the immunosuppressive adjuvants, azathioprine, or mycophenolate mofetil, respectively.…”

Section: Discussionmentioning

confidence: 99%

Targeted Immunotherapy with Rituximab Leads to a Transient Alteration of the IgG Autoantibody Profile in Pemphigus Vulgaris

Müller

Hunzelmann

Baur

et al. 2010

Dermatology Research and Practice

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In pemphigus vulgaris (PV), IgG autoantibodies against the ectodomain of desmoglein 3 (Dsg3) have been shown to be directly responsible for the loss of keratinocyteadhesion. The aim of the present study was to study the effect of the B cell depleting anti-CD20 monoclonal antibody, rituximab, on the profile of pathogenic IgG against distinct regions of the Dsg3 ectodomain in 22 PV patients who were followed up clinically and serologically by Dsg3 ELISA over 12-24 months. Prior to rituximab, all the 22 PV patients showed IgG against Dsg3 (Dsc3EC1-5). Specifically, 14/22 showed IgG reactivity against the Dsg3EC1 subdomain, 5/22 patients against Dsg3EC2, 7/22 against Dsg3EC3, 11/22 against Dsg3EC4, and 2/22 against Dsg3EC5. Within 6 months after rituximab, all the patients showed significant clinical improvement and reduced IgG against Dsg3 (5/22) and the various subdomains, that is, Dsg3EC1 (7/22), Dsg3EC2 (3/22), Dsg3EC3 (2/22), sg3EC4 (2/22), and Dsg3EC5 (0/22). During the entire observation period, 6/22 PV patients experienced a clinical relapse which was associated with the reappearance of IgG against previously recognized Dsg3 subdomains, particularly against the Dsg3EC1. Thus, in PV, rituximab only temporarily depletes pathogenic B cell responses against distinct subdomains of Dsg3 which reappear upon clinical relapse.

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Section: Discussionmentioning

confidence: 99%

Targeted Immunotherapy with Rituximab Leads to a Transient Alteration of the IgG Autoantibody Profile in Pemphigus Vulgaris

Müller

Hunzelmann

Baur

et al. 2010

Dermatology Research and Practice

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“…Similarly, treatment with a chimeric monoclonal antibody against the CD20 cell surface antigen of B lymphocytes, rituximab (Rtx), leads to a rapid and prolonged B‐cell depletion which is associated with a decrease of pathogenic auto‐Abs and significant clinical improvement in autoimmune disorders 25 . Over the past few years, several groups have reported the successful treatment of patients with pemphigus by anti‐CD20 immunotherapy 26–31 …”

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confidence: 99%

Combined treatment with immunoadsorption and rituximab leads to fast and prolonged clinical remission in difficult-to-treat pemphigus vulgaris

Behzad¹,

Möbs²,

Kneisel³

et al. 2012

British Journal of Dermatology

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“…In the case reported here, the early use of rituximab might have diminished the hospitalization time, which was 7 months in total, and also mitigated the various complications secondary to the use of corticoids and immunosuppressants. 2,7-10 …”

Section: Discussionmentioning

confidence: 99%

Severe Multi-Resistant Pemphigus vulgaris: prolonged remission with a single cycle of Rituximab

Corral

Freitas

Aquino

et al. 2013

An. Bras. Dermatol.

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Pemphigus vulgaris is an autoimmune bullous disease whose therapy is based on systemic corticosteroids, with or without immunosuppressants. Rituximab is a chimeric monoclonal antibody of the IgG class, directed at a specific CD20 B cell surface antigen, used in pemphigus vulgaris empirically since 2002, with success in 90% of the cases and long periods of remission. Male patient, 33 years old, diagnosed with pemphigus vulgaris, confirmed by histopathology and direct immunofluorescence. He was treated for seven months with numerous treatments, including immunosuppressive drugs, with an unsatisfactory response, until he had complete remission with the use of rituximab. During a 34-month follow-up period, the patient presented a slight clinical relapse, which was successfully controlled with prednisone in a daily dose of 120mg, soon reduced to 20mg.

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Rituximab (Anti-CD20 Monoclonal Antibody) – Ultimate or First Choice in Pemphigus?

Cited by 14 publications

References 10 publications

Targeted Immunotherapy with Rituximab Leads to a Transient Alteration of the IgG Autoantibody Profile in Pemphigus Vulgaris

Targeted Immunotherapy with Rituximab Leads to a Transient Alteration of the IgG Autoantibody Profile in Pemphigus Vulgaris

Combined treatment with immunoadsorption and rituximab leads to fast and prolonged clinical remission in difficult-to-treat pemphigus vulgaris

Severe Multi-Resistant Pemphigus vulgaris: prolonged remission with a single cycle of Rituximab

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