The emerging role of rituximab in autoimmune blistering diseases

American Journal of Clinical Dermatology
A Razzaque Ahmed, Shawn Shetty

Abstract

Rituximab is a chimeric monoclonal antibody that selectively binds to the CD20 molecule on B cells, resulting in their lysis. In autoimmune blistering diseases, the auto-antibody-producing B cells are destroyed and auto-antibody levels are reduced or eliminated. In the majority of patients, rituximab produces rapid clinical response and early resolution. In part, this accounts for the increased use of rituximab. Rituximab does not distinguish normal from pathologic B cells. Hence, shortly after its use, B-cell levels are zero and remain so for several months. In most patients, the use of systemic corticosteroids and immunosuppressive agents are continued after rituximab therapy, while their dosages are significantly decreased. In the majority of patients rituximab is used according to the protocol used in treating lymphoma patients or patients with rheumatoid arthritis. Approximately 50% of patients experience a relapse, requiring additional therapy. Serious adverse events and fatal outcomes have been reported, although their incidence is less than that observed with conventional therapy. Nonetheless, the causes, i.e. infections and septicemia, are similar. Several gaps exist in our understanding of how to optimally benefit fro...Continue Reading

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Citations

Dec 19, 2018·Expert Opinion on Biological Therapy·Mauro Alaibac
May 1, 2018·International Journal of Dermatology·Sara B HuffBenjamin H Kaffenberger
Oct 3, 2019·Expert Review of Clinical Immunology·Rebecca L YanovskyA Razzaque Ahmed
Mar 22, 2018·Journal of Clinical Rheumatology : Practical Reports on Rheumatic & Musculoskeletal Diseases·Anna E Kersh, Ron J Feldman

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