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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

Baseline and post-rituximab status of PDAI, anti-Dsg1 and anti-Dsg3 antibody titers, and CD20 positive cells fraction
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T1: Baseline and post-rituximab status of PDAI, anti-Dsg1 and anti-Dsg3 antibody titers, and CD20 positive cells fraction

Mentions: A total of 24 patients with recalcitrant PV were enrolled in the study and treated with rituximab, from which 18 patients (13 men and 5 women) attended both of the follow-up sessions and included in the final analysis. Among these patients, 5 had mucosal and 13 had mucocutaneous PV. The median (interquartile range) age of the patients was 33.5 (26‒46.5) years. At the outset of the study, all of the patients were on prednisolone therapy 20‒90 mg daily, and 9 of them were concurrently receiving immunosuppressants (2 patients: mycophenolate mofetil 2 g daily; 4 patients: azathioprine 100 mg daily; and 3 patients: methotrexate 7.5‒10 mg weekly). The baseline and post-rituximab PDAI score, anti-Dsg1 and anti-Dsg3 antibody titers, and CD20 positive cells fraction are presented in Table 1(Tab. 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)

Baseline and post-rituximab status of PDAI, anti-Dsg1 and anti-Dsg3 antibody titers, and CD20 positive cells fraction
© Copyright Policy - open-access
Related In: Results  -  Collection

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

T1: Baseline and post-rituximab status of PDAI, anti-Dsg1 and anti-Dsg3 antibody titers, and CD20 positive cells fraction
Mentions: A total of 24 patients with recalcitrant PV were enrolled in the study and treated with rituximab, from which 18 patients (13 men and 5 women) attended both of the follow-up sessions and included in the final analysis. Among these patients, 5 had mucosal and 13 had mucocutaneous PV. The median (interquartile range) age of the patients was 33.5 (26‒46.5) years. At the outset of the study, all of the patients were on prednisolone therapy 20‒90 mg daily, and 9 of them were concurrently receiving immunosuppressants (2 patients: mycophenolate mofetil 2 g daily; 4 patients: azathioprine 100 mg daily; and 3 patients: methotrexate 7.5‒10 mg weekly). The baseline and post-rituximab PDAI score, anti-Dsg1 and anti-Dsg3 antibody titers, and CD20 positive cells fraction are presented in Table 1(Tab. 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