Journal
IMMUNOTHERAPY
Volume 10, Issue 1, Pages 27-37Publisher
FUTURE MEDICINE LTD
DOI: 10.2217/imt-2017-0104
Keywords
anti-desmoglein antibodies; autoimmune regimen; B lymphocytes; CD20; corticosteroids; efficacy; pemphigus superficial; pemphigus vulgaris; rituximab; safety
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Pemphigus is a severe autoimmune blistering diseasemediated by pathogenic anti-desmoglein antibodies leading to an inter keratinocyte disjunction. Rituximab is a monoclonal antibody that binds to the CD-20 antigen of B lymphocytes, which causes B-cell depletion and a subsequent reduction in pathogenic autoantibodies. Its therapeutic role in pemphigus has been progressively growing with increasing evidence of successful outcomes. Rituximab was initially off-labeled used as an alternative in patients with recalcitrant or relapsing pemphigus and in patients with contraindications to systemic corticosteroids. Recently, a large randomized clinical trial has shown that first-line use of rituximab combined with short-term prednisone regimen was both more effective and potentially safer than a standard regimen of high doses of corticosteroids in patients with moderate to severe pemphigus.
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