Rituximab combined with conventional therapy versus conventional therapy alone for the treatment of mucous membrane pemphigoid (MMP)

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• 作者：Alexander Maley ; MD^a ; Maxine Warren ; BS^a ; Ilyse Haberman ; MD^b ; Robert Swerlick ; MD^a ; Bhairavi Kharod-Dholakia ; MD^b ; Ron Feldman ; MD ; PhD^a ; ^{ron.j.feldman@emory.edu" class="auth_mail" title="E-mail the corresponding author}
• 关键词：autoimmune blistering disease ; cicatricial pemphigoid ; immunosuppression ; mucous membrane pemphigoid ; ocular pemphigoid ; rituximab
• 刊名：Journal of the American Academy of Dermatology
• 出版年：2016
• 出版时间：May 2016
• 年：2016
• 卷：74
• 期：5
• 页码：835-840
• 全文大小：126 K

文摘

The use of rituximab for refractory autoimmune blistering diseases is increasing. Data related to rituximab for the treatment of mucous membrane pemphigoid (MMP) are limited.

Objective

We sought to compare the efficacy of adding rituximab with traditional immunosuppressive therapies in the treatment of MMP. The primary outcome was achievement and time to disease control.

Methods

Patients with a diagnosis of MMP from August 2001 to June 2015 who had greater than 6 months of follow-up after the initiation of therapy were reviewed.

Results

In all, 24 patients were treated with rituximab and 25 were treated with conventional immunosuppression. Of patients, 100% in the rituximab group achieved disease control compared with 40% in the conventional group (P < .01), with a mean time to disease control of 10.17 months and 37.7 months (P = .02). Adverse events were seen in 33% of patients after rituximab, compared with 48% of patients in the conventional group (P = .2).

Limitations

Rituximab dosing was not uniform and the 2 groups were not matched in terms of disease severity, nor were they randomized.

Conclusions

Our study indicates that the addition of rituximab to conventional therapy in patients with MMP results in more rapid and sustained disease control with potentially fewer adverse events.