Rituximab and low dose oral immune modulating treatment to maintain a sustained response in severe pemphigus patients.

Autor: Keeley JM; a School of Medicine , University of Alabama at Birmingham , Birmingham , AL , USA., Bevans SL; a School of Medicine , University of Alabama at Birmingham , Birmingham , AL , USA., Jaleel T; b Department of Dermatology , Duke University Medical Center , Durham , NC , USA., Sami N; c Department of Medicine , University of Central Florida , Orlando , FL , USA.
Jazyk: angličtina
Zdroj: The Journal of dermatological treatment [J Dermatolog Treat] 2019 Jun; Vol. 30 (4), pp. 340-345. Date of Electronic Publication: 2018 Sep 07.
DOI: 10.1080/09546634.2018.1510173
Abstrakt: Objectives: This pilot retrospective study examined the role of continuous low-dose maintenance immunomodulatory treatment (IMT) as an adjunct to rituximab (RTX) rescue therapy in severe pemphigus vulgaris (PV) and pemphigus foliaceus (PF) after a complete response (CR) to RTX was achieved. Materials and methods: Ten severe pemphigus patients who received RTX rescue therapy were evaluated after achieving CR. The post-RTX clinical course and long-term follow up was compared between patients who adhered to a low recommended dose (LRMD) to patients who were non-compliant with LRMD. Results: Five patients relapsed due to discontinuing or tapering their LRMD therapy, whereas the five patients who adhered to their maintenance therapy did not experience a relapse after the initial post-RTX CR. A combination of increasing or adding IMTs and initiating subsequent RTX cycles was used to regain control in relapsed patients. Conclusions: We propose an alternative treatment strategy utilizing RTX as a rescue agent in combination with long-term LRMD as a means to maintain a sustained long-term CR post-RTX therapy in severe pemphigus patients. This strategy could prevent disease flares and the need for additional RTX cycles and higher dosages of immunomodulatory therapies.
Databáze: MEDLINE
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