Rituximab: A monoclonal antibody to CD20 used in the treatment of pemphigus vulgaris - 09/08/11

Doi : 10.1016/j.jaad.2006.05.009

Abdul Kader El Tal, MD ^a, Marshall R. Posner, MD ^b, Zachary Spigelman, MD ^c, A. Razzaque Ahmed, MD ^a,^d,^⁎
^a From the Department of Medicine, New England Baptist Hospital and Department of Oral Medicine, Infection & Immunity, Harvard School of Dental Medicine
^b Dana Farber Cancer Institute and Harvard Medical School
^c Parker Hill Oncology and Harvard Medical School
^d Center for Blistering Diseases, New England Baptist Hospital (Director)

Reprint requests: A. Razzaque Ahmed, MD, Center for Blistering Diseases, New England Baptist Hospital, 70 Parker Hill Ave, Suite 208, Boston, MA 02120.

Boston, Massachusetts

Abstract

Background

Rituximab is an anti-CD20 chimeric antibody that selectively targets B lymphocytes. Recently, it has been reported to be beneficial in treating pemphigus vulgaris.

Objective

Our aim was to review the English-language literature on the treatment of pemphigus vulgaris (PV) with rituximab and to determine its efficacy and influence on clinical outcome(s).

Material and methods

A retrospective review of the literature on the use of rituximab in the treatment of PV was conducted. Seventeen patients in 10 reports were described and their data were reviewed.

Results

The majority of patients received one course of rituximab along with conventional immunosuppressive therapy as concomitant therapy; 88% of the patients demonstrated improvement. More than half of the patients were followed up for more than 6 months after rituximab treatment; they appeared to be clinically disease free, but were still receiving conventional immunosuppressive therapy. Side effects in most patients were transient and infusion related. Serious infections occurred in 4 patients. One patient died.

Limitations

The sample size of this study is small; there is no uniformity of data collection or measurement of key and critical indices, and follow-up was limited.