Rituximab therapy in patients with bullous pemphigoid: A retrospective study of 20 patients

Bullous pemphigoid (BP) is the most common autoimmune blistering disease requiring treatment with immunosuppressive medications; however, finding a therapy that has a sustained durable response and an acceptable side effect profile has been challenging. Our study aimed to evaluate the clinical outco...

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Bibliographic Details
Published in:Journal of the American Academy of Dermatology 2019-07, Vol.81 (1), p.179-186
Main Authors: Polansky, Maxim, Eisenstadt, Rachel, DeGrazia, Taryn, Zhao, Xiwen, Liu, Yuan, Feldman, Ron
Format: Article
Language:English
Subjects:
Academic Medical Centers
Adult
Antibodies, Monoclonal - adverse effects
Antibodies, Monoclonal - therapeutic use
autoimmune blistering disease
bullous pemphigoid
Cohort Studies
Dose-Response Relationship, Drug
Drug Administration Schedule
Female
Follow-Up Studies
Georgia
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Pemphigoid, Bullous - diagnosis
Pemphigoid, Bullous - drug therapy
relapse
remission
Retrospective Studies
Risk Assessment
rituximab
Rituximab - adverse effects
Rituximab - therapeutic use
Severity of Illness Index
Time Factors
Treatment Outcome
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Summary:Bullous pemphigoid (BP) is the most common autoimmune blistering disease requiring treatment with immunosuppressive medications; however, finding a therapy that has a sustained durable response and an acceptable side effect profile has been challenging. Our study aimed to evaluate the clinical outcomes of patients with BP treated with rituximab therapy at a single academic center. A retrospective chart review was performed on 20 patients who received at least 1 dose of rituximab therapy, either as initial therapy for severe BP or as therapy for recalcitrant disease after having failed conventional immunotherapies. Within our cohort, 75% of patients (n = 15) achieved remission an average of 169 days following rituximab therapy. There were no rituximab-related deaths and significantly fewer adverse events following rituximab therapy. This study was limited by its retrospective nature, focus on a single academic center, and small sample size. Use of rituximab therapy demonstrated high rates of remission, steroid-sparing activity, and an acceptable safety profile in our cohort of patients with severe BP or disease refractory to conventional therapies.
ISSN:0190-9622
1097-6787
DOI:10.1016/j.jaad.2019.03.049