Limits...
Rituximab therapy improves recalcitrant Pemphigus vulgaris.

Noormohammadpour P, Ehsani A, Mortazavi H, Daneshpazhooh M, Balighi K, Mofidi M, Gholamali F, Sadeghinia A - EXCLI J (2015)

Bottom Line: Rituximab therapy caused a dramatic reduction in the PDAI, accompanied by decreases in anti-desmoglein 1 and anti-desmoglein 3 antibody titers over the follow-up course.The B-cell population decreased at the first follow-up, but returned to its baseline levels at the second follow-up.It seems that the rituximab may be effective and safe for treatment of refractory PV.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran ; Bullous Research Center, Tehran University of Medical Sciences, Tehran, Iran.

ABSTRACT
Pemphigus is a severe life-threatening blistering disease associated with autoantibodies against cell adhesion proteins desmogleins 1 and 3. Patients with severe pemphigus commonly show high rates of relapse after conventional immunosuppressive therapy. The newly developed drug Rituximab showed impressing promises in the treatment of refractory pemphigus vulgaris (PV). In the present study the efficacy of a single course rituximab therapy in the treatment of PV was investigated. Eighteen patients with severe recalcitrant PV were recruited to this study. Pemphigus disease activity index (PDAI), anti-desmoglein 1 and anti-desmoglein 3 antibody titers, and percent of CD20 positive cells were measured at baseline, 10 ± 1, and 22 ± 2 weeks after rituximab therapy. Rituximab was given intravenously at dose 375 mg/m(2) once weekly for 4 weeks. Rituximab therapy caused a dramatic reduction in the PDAI, accompanied by decreases in anti-desmoglein 1 and anti-desmoglein 3 antibody titers over the follow-up course. The B-cell population decreased at the first follow-up, but returned to its baseline levels at the second follow-up. Rituximab therapy decreased the dose of immunosuppressive drugs required to control the disease. It seems that the rituximab may be effective and safe for treatment of refractory PV.

No MeSH data available.


Related in: MedlinePlus

Scatterplot showing the number of patients with negative (-), intermediate (×), and positive (+) anti-Dsg1 (A) and anti-Dsg3 (B) antibody titers over the rituximab treatment and follow-up course. Apparently, rituximab therapy decreased the number of patients with positive anti-Dsg1 and anti-Dsg3 titers. The gridlines represent the lower and upper limits of negative, intermediate, and positive titers.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4553899&req=5

Figure 1: Scatterplot showing the number of patients with negative (-), intermediate (×), and positive (+) anti-Dsg1 (A) and anti-Dsg3 (B) antibody titers over the rituximab treatment and follow-up course. Apparently, rituximab therapy decreased the number of patients with positive anti-Dsg1 and anti-Dsg3 titers. The gridlines represent the lower and upper limits of negative, intermediate, and positive titers.

Mentions: There was a significant overall change in anti-Dsg1 antibody titer over the treatment and follow-up course [Friedman's test: Χ2 (2) = 12.19, p = 0.002]. Pairwise comparisons revealed that the antibody titer decreased significantly 10 weeks after the rituximab treatment relative to the baseline levels (Z = -3.33, p = 0.001), but there was no significant change occurred at the second follow-up occasion (Z = -1.76, p = 0.07 compared with the baseline; Z = -0.16, p = 0.86 compared with the first follow-up). Moreover, an overall significant difference was found in the anti-Dsg3 antibody titer over the treatment and follow-up period [Friedman's test: Χ2 (2) = 11.74, p = 0.003]. Post hoc analysis with Wilcoxon test showed that the anti-Dsg3 antibody decreased after the rituximab treatment (Z = -3.10, p = 0.002) but remained stable over the later follow-up course (Z = -2.41, p = 0.01 compared with the baseline; Z = -0.41, p = 0.68 compared with the first follow-up). Rituximab therapy decreased the number of patients with positive levels of anti-Dsg1 and anti-Dsg3 antibodies (Figure 1(Fig. 1)).


Rituximab therapy improves recalcitrant Pemphigus vulgaris.

Noormohammadpour P, Ehsani A, Mortazavi H, Daneshpazhooh M, Balighi K, Mofidi M, Gholamali F, Sadeghinia A - EXCLI J (2015)

Scatterplot showing the number of patients with negative (-), intermediate (×), and positive (+) anti-Dsg1 (A) and anti-Dsg3 (B) antibody titers over the rituximab treatment and follow-up course. Apparently, rituximab therapy decreased the number of patients with positive anti-Dsg1 and anti-Dsg3 titers. The gridlines represent the lower and upper limits of negative, intermediate, and positive titers.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4553899&req=5

Figure 1: Scatterplot showing the number of patients with negative (-), intermediate (×), and positive (+) anti-Dsg1 (A) and anti-Dsg3 (B) antibody titers over the rituximab treatment and follow-up course. Apparently, rituximab therapy decreased the number of patients with positive anti-Dsg1 and anti-Dsg3 titers. The gridlines represent the lower and upper limits of negative, intermediate, and positive titers.
Mentions: There was a significant overall change in anti-Dsg1 antibody titer over the treatment and follow-up course [Friedman's test: Χ2 (2) = 12.19, p = 0.002]. Pairwise comparisons revealed that the antibody titer decreased significantly 10 weeks after the rituximab treatment relative to the baseline levels (Z = -3.33, p = 0.001), but there was no significant change occurred at the second follow-up occasion (Z = -1.76, p = 0.07 compared with the baseline; Z = -0.16, p = 0.86 compared with the first follow-up). Moreover, an overall significant difference was found in the anti-Dsg3 antibody titer over the treatment and follow-up period [Friedman's test: Χ2 (2) = 11.74, p = 0.003]. Post hoc analysis with Wilcoxon test showed that the anti-Dsg3 antibody decreased after the rituximab treatment (Z = -3.10, p = 0.002) but remained stable over the later follow-up course (Z = -2.41, p = 0.01 compared with the baseline; Z = -0.41, p = 0.68 compared with the first follow-up). Rituximab therapy decreased the number of patients with positive levels of anti-Dsg1 and anti-Dsg3 antibodies (Figure 1(Fig. 1)).

Bottom Line: Rituximab therapy caused a dramatic reduction in the PDAI, accompanied by decreases in anti-desmoglein 1 and anti-desmoglein 3 antibody titers over the follow-up course.The B-cell population decreased at the first follow-up, but returned to its baseline levels at the second follow-up.It seems that the rituximab may be effective and safe for treatment of refractory PV.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran ; Bullous Research Center, Tehran University of Medical Sciences, Tehran, Iran.

ABSTRACT
Pemphigus is a severe life-threatening blistering disease associated with autoantibodies against cell adhesion proteins desmogleins 1 and 3. Patients with severe pemphigus commonly show high rates of relapse after conventional immunosuppressive therapy. The newly developed drug Rituximab showed impressing promises in the treatment of refractory pemphigus vulgaris (PV). In the present study the efficacy of a single course rituximab therapy in the treatment of PV was investigated. Eighteen patients with severe recalcitrant PV were recruited to this study. Pemphigus disease activity index (PDAI), anti-desmoglein 1 and anti-desmoglein 3 antibody titers, and percent of CD20 positive cells were measured at baseline, 10 ± 1, and 22 ± 2 weeks after rituximab therapy. Rituximab was given intravenously at dose 375 mg/m(2) once weekly for 4 weeks. Rituximab therapy caused a dramatic reduction in the PDAI, accompanied by decreases in anti-desmoglein 1 and anti-desmoglein 3 antibody titers over the follow-up course. The B-cell population decreased at the first follow-up, but returned to its baseline levels at the second follow-up. Rituximab therapy decreased the dose of immunosuppressive drugs required to control the disease. It seems that the rituximab may be effective and safe for treatment of refractory PV.

No MeSH data available.


Related in: MedlinePlus