Premium
Rituximab in practice: Clinical evaluation of patients with pemphigus after rituximab administration
Author(s) -
Mahmoudi Hamidreza,
Tavakolpour Soheil,
Balighi Kamran,
Farid Ali Salehi,
Nili Ali,
Jan Delnavaz,
Daneshpazhooh Maryam
Publication year - 2020
Publication title -
dermatologic therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.595
H-Index - 68
eISSN - 1529-8019
pISSN - 1396-0296
DOI - 10.1111/dth.14633
Subject(s) - medicine , rituximab , pemphigus , dermatology , clinical practice , lymphoma , family medicine
Pemphigus Vulgaris (PV) is a rare autoimmune blistering disease, which mainly causes mucosal and/or cutaneous lesions. In June 2018, FDA approved Rituximab (RTX)—a B‐cell depleting agent—for the management of patients with moderate‐to‐severe pemphigus. Although the majority of patients respond well to this drug, some do not reach complete remission with a single cycle of RTX. In this review, following an overview of RTX and its clinical outcomes, we have focused on the possible outcomes after RTX therapy in patients with PV. The response is defined into four main categories; complete responders, partial responders, nonresponders, and paradoxical reactions, based on three possibilities of reaching the consolidation phase after 3 months, reaching remission until 6 months, and the ability of corticosteroid tapering in 6 months after RTX administration. Concerning the safety of RTX, three categories of infusion reactions, short and long‐term side effects are discussed. Additionally, we have suggested approaches for the evaluation of clinical and serological responses at different critical time‐points, including 1, 2, 3, and 6 months after RTX administration. Finally, available markers to predict the response to RTX and research gaps in the field of RTX therapy have been summarized.