Abstract | BACKGROUND:
Pemphigus vulgaris (PV) is a severe antibody-mediated autoimmune blistering disease. Because some patients with PV do not enter into remission, despite the use of high-dose corticosteroid therapy and immunosuppressive adjuvant treatments, new effective and safer agents are warranted to treat refractory PV. Rituximab, a monoclonal anti-CD20 antibody, induces depletion of B cells in vivo and has shown efficacy in patients with refractory antibody-mediated autoimmune disorders. We describe herein 3 patients treated with rituximab for severe PV. OBSERVATIONS: Three patients with refractory PV were treated with rituximab, resulting in a clinical response in all patients, which was complete in 2 patients. A decline in titers of circulating antiepidermis autoantibodies paralleled disease activity, while circulating B cells remained undetectable for 6 to 10 months. Two patients experienced bacterial infection in the weeks following the rituximab course. A clinical relapse occurred in 2 patients, at 6 and 10 months. A second course of rituximab controlled the disease in one of them. CONCLUSION: These patients' response suggests that rituximab may be a valuable treatment for refractory PV and warrants further studies to evaluate the risk-benefit ratio in patients with PV showing resistance to classic therapy.
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Authors | Alain Dupuy, Manuelle Viguier, Christophe Bédane, Florence Cordoliani, Sophie Blaise, Françoise Aucouturier, Jean-Marie Bonnetblanc, Patrice Morel, Louis Dubertret, Hervé Bachelez |
Journal | Archives of dermatology
(Arch Dermatol)
Vol. 140
Issue 1
Pg. 91-6
(Jan 2004)
ISSN: 0003-987X [Print] United States |
PMID | 14732665
(Publication Type: Case Reports, Journal Article)
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Chemical References |
- Antibodies, Monoclonal
- Antibodies, Monoclonal, Murine-Derived
- Autoantibodies
- Rituximab
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Topics |
- Adult
- Antibodies, Monoclonal
(therapeutic use)
- Antibodies, Monoclonal, Murine-Derived
- Autoantibodies
(blood)
- Epidermis
(immunology)
- Female
- Humans
- Male
- Pemphigus
(drug therapy, immunology, pathology)
- Rituximab
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