Treatment of refractory pemphigus vulgaris with rituximab (anti-CD20 monoclonal antibody)
Treatment of refractory pemphigus vulgaris with rituximab (anti-CD20 monoclonal antibody)
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DOI：
10.1001/archderm.140.1.91
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发表时间：
2004-01-01
影响因子：
--
通讯作者：
Bachelez, H
中科院分区：
文献类型：
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作者：
Dupuy, A;Viguier, M;Bachelez, H
背景：寻常天疱疮（PV）是一种严重的抗体介导的自身免疫性水疱病。由于一些PV患者即使使用高剂量皮质类固醇治疗和免疫抑制剂辅助治疗也不能进入缓解期，因此需要新的有效和更安全的药物来治疗难治性PV。利妥昔单抗是一种单克隆抗CD20抗体，可诱导体内B细胞耗竭，并已在难治性抗体介导的自身免疫性疾病患者中显示出疗效。我们在此描述了3例患者用利妥昔单抗治疗严重PV。观察结果：3例难治性PV患者用利妥昔单抗治疗，导致所有患者的临床反应，其中2例患者完成。循环中抗表皮自身抗体滴度的下降预示着疾病的活动性，而循环中的B细胞在6至10个月内仍无法检测到。两名患者在利妥昔单抗疗程后的几周内发生细菌感染。2例患者在6个月和10个月时发生临床复发。利妥昔单抗的第二个过程中控制的疾病之一them.Conclusion：这些患者的反应表明，利妥昔单抗可能是一个有价值的治疗难治性PV，并值得进一步研究，以评估风险效益比PV显示耐药经典疗法的患者。
Background: Pemphigus vulgaris (PV) is a severe antibody-mediated autoimmune blistering disease. Because some patients with PV do not enter into remission, despite the use of high-dose corticosteroid therapy and immunosuppressive adjuvant treatments, new effective and safer agents are warranted to treat refractory PV. Rituximab, a monoclonal anti-CD20 antibody, induces depletion of B cells in vivo and has shown efficacy in patients with refractory antibody-mediated autoimmune disorders. We describe herein 3 patients treated with rituximab for severe PV.Observations: Three patients with refractory PV were treated with rituximab, resulting in a clinical response in all patients, which was complete in 2 patients. A decline in titers of circulating antiepidermis autoantibodies paralleled disease activity, while circulating B cells remained undetectable for 6 to 10 months. Two patients experienced bacterial infection in the weeks following the rituximab course. A clinical relapse occurred in 2 patients, at 6 and 10 months. A second course of rituximab controlled the disease in one of them.Conclusion: These patients' response suggests that rituximab may be a valuable treatment for refractory PV and warrants further studies to evaluate the risk-benefit ratio in patients with PV showing resistance to classic therapy.