Future therapies for pemphigus vulgaris: Rituximab and beyond

The conventional treatment for patients with pemphigus vulgaris (PV) centers on global immunosuppression, such as the use of steroids and other immunosuppressive drugs, to decrease titers of antidesmoglein autoantibodies responsible for the acantholytic blisters. Global immunosuppressants, however,...

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Bibliographic Details
Published in:Journal of the American Academy of Dermatology 2016-04, Vol.74 (4), p.746-753
Main Authors: Huang, Amy, BA, Madan, Raman K., MD, Levitt, Jacob, MD
Format: Article
Language:English
Subjects:
anti-CD20
Antibodies, Monoclonal - adverse effects
Antibodies, Monoclonal - therapeutic use
Antibodies, Monoclonal, Humanized - adverse effects
Antibodies, Monoclonal, Humanized - therapeutic use
autoimmune
Biological Products - adverse effects
Biological Products - therapeutic use
biologics
blistering diseases
Cohort Studies
Dermatology
desmoglein
desmosomes
Female
Forecasting
Humans
immunomodulators
immunosuppression
Immunosuppressive Agents - adverse effects
Immunosuppressive Agents - therapeutic use
Male
monoclonal antibodies
Pemphigus - diagnosis
Pemphigus - drug therapy
pemphigus vulgaris
Prognosis
Prospective Studies
Risk Assessment
rituximab
Rituximab - adverse effects
Rituximab - therapeutic use
Treatment Outcome
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Summary:The conventional treatment for patients with pemphigus vulgaris (PV) centers on global immunosuppression, such as the use of steroids and other immunosuppressive drugs, to decrease titers of antidesmoglein autoantibodies responsible for the acantholytic blisters. Global immunosuppressants, however, cause serious side effects. The emergence of anti-CD20 biologic medications, such as rituximab, as an adjunct to conventional therapy has shifted the focus to targeted destruction of autoimmune B cells. Next-generation biologic medications with improved modes of delivery, pharmacology, and side effect profiles are constantly being developed, adding to the diversity of options for PV treatment. We review promising monoclonal antibodies, including veltuzumab, obinutuzumab (GA-101), ofatumumab, ocaratuzumab (AME-133v), PRO131921, and belimumab.
ISSN:0190-9622
1097-6787
DOI:10.1016/j.jaad.2015.11.008