Rituximab therapy in patients with bullous pemphigoid: A retrospective study of 20 patients

J Am Acad Dermatol. 2019 Jul;81(1):179-186. doi: 10.1016/j.jaad.2019.03.049. Epub 2019 Mar 25.

Abstract

Background: Bullous pemphigoid (BP) is the most common autoimmune blistering disease requiring treatment with immunosuppressive medications; however, finding a therapy that has a sustained durable response and an acceptable side effect profile has been challenging.

Objective: Our study aimed to evaluate the clinical outcomes of patients with BP treated with rituximab therapy at a single academic center.

Methods: A retrospective chart review was performed on 20 patients who received at least 1 dose of rituximab therapy, either as initial therapy for severe BP or as therapy for recalcitrant disease after having failed conventional immunotherapies.

Results: Within our cohort, 75% of patients (n = 15) achieved remission an average of 169 days following rituximab therapy. There were no rituximab-related deaths and significantly fewer adverse events following rituximab therapy.

Limitations: This study was limited by its retrospective nature, focus on a single academic center, and small sample size.

Conclusion: Use of rituximab therapy demonstrated high rates of remission, steroid-sparing activity, and an acceptable safety profile in our cohort of patients with severe BP or disease refractory to conventional therapies.

Keywords: autoimmune blistering disease; bullous pemphigoid; relapse; remission; rituximab.

MeSH terms

  • Academic Medical Centers
  • Adult
  • Antibodies, Monoclonal / adverse effects
  • Antibodies, Monoclonal / therapeutic use*
  • Cohort Studies
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Female
  • Follow-Up Studies
  • Georgia
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Pemphigoid, Bullous / diagnosis*
  • Pemphigoid, Bullous / drug therapy*
  • Retrospective Studies
  • Risk Assessment
  • Rituximab / adverse effects
  • Rituximab / therapeutic use*
  • Severity of Illness Index
  • Time Factors
  • Treatment Outcome

Substances

  • Antibodies, Monoclonal
  • Rituximab