Efficacy and safety of rituximab in pemphigus: experience of the German Registry of Autoimmune Diseases.

Abstract

BACKGROUND:

Rituximab has been reported to be effective in various small case series of patients with severe and/or refractory pemphigus. However, no systematic evaluation is available to corroborate this observation. The aim of this study was to systematically determine efficacy and safety of rituximab in treatment-resistant pemphigus.

PATIENTS AND METHODS:

Multicenter retrospective, observational study of 36 patients with severe pemphigus vulgaris (n = 33) and pemphigus foliaceus (n = 3) treated with rituximab before August 31(st) , 2008 and enrolled in a national observational registery between December 2008 and June 2009.

RESULTS:

Within a mean period of observation of 11 (1-37) months, 21 (58 %) pemphigus patients showed complete, 13 (36 %) partial, and 2 (6 %) no response to rituximab treatment. This correlates with a mean improvement of the visual analog scale for well-being of 34 (20-60) at baseline to 75 (40-95) at the last control visit. In 4 (11 %) patients, severe adverse events were recorded including 1 (3 %) serious infection.

CONCLUSIONS:

Data collected in this systematic registry indicate that rituximab is an effective and relatively safe adjuvant treatment option for refractory pemphigus. To further extend our knowledge on efficacy and safety of this drug, controlled prospective trials are required.

• Authors: Michael Kasperkiewicz, Rüdiger Eming, Melika Behzad, Nicolas Hunzelmann, Michael Meurer, Hendrik Schulze-Koops, Peter von Wussow, Michael Hertl, Detlef Zillikens, Klaus Freivogel, Thomas Dörner, Enno Schmidt
• Journal: Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG (J Dtsch Dermatol Ges) Vol. 10 Issue 10 Pg. 727-32 (Oct 2012) ISSN: 1610-0387 [Electronic] Germany
• PMID: 22577946 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
• Copyright: © The Authors • Journal compilation © Blackwell Verlag GmbH, Berlin.

Chemical References

• Antibodies, Monoclonal, Murine-Derived
• Immunologic Factors
• Rituximab

Topics

• Adolescent
• Adult
• Aged
• Antibodies, Monoclonal, Murine-Derived (adverse effects, therapeutic use)
• Comorbidity
• Drug-Related Side Effects and Adverse Reactions (epidemiology)
• Female
• Germany (epidemiology)
• Humans
• Immunologic Factors (adverse effects, therapeutic use)
• Male
• Middle Aged
• Pemphigus (drug therapy, epidemiology)
• Prevalence
• Registries
• Risk Factors
• Rituximab
• Treatment Outcome
• Young Adult