Can rituximab be used in the treatment of pemphigus vulgaris during the
            <scp>COVID</scp>
            ‐19 pandemic?

Uzunçakmak, Tuğba Kevser; Özkoca, Defne; Aşkın, Özge; Kutlubay, Zekayі

doi:10.1111/dth.14647

Cited by 12 publications

(14 citation statements)

References 16 publications

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“…Uzuncakmak et al reported only one case of COVID-19 among 48 pemphigus patients treated with RTX during the past five years. The patient received RTX seven months before COVID-19 and had a mild course (15). Recently, Mahmoudi et al reported 21 COVID-19 cases from a cohort of patients with AIBDs.…”

Section: Discussionmentioning

confidence: 99%

Case Report: Complete and Fast Recovery From Severe COVID-19 in a Pemphigus Patient Treated With Rituximab

et al. 2021

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COVID-19 is characterized by a severe pulmonary disease due to severe acute respiratory syndrome (SARS)-CoV-2 infection. For clinicians involved in the management of patients with chronic autoimmune diseases the risk linked to the conditions itself and to drug-induced immunosuppression during the COVID-19 pandemic is a major topic. Pemphigus is a rare autoimmune blistering disease (AIBD) of the skin and mucous membranes caused by autoantibodies to desmosomal components, desmoglein 1 and 3. Among immunosuppressant therapies, rituximab (RTX) is considered a highly effective treatment with a favorable safety profile, but it induces a prolonged B-cell depletion that can lead to higher susceptibility to infections. For this reason, concerns about its use during the pandemic have been raised. We describe a case of a pemphigus patient in which RTX-induced B cell depletion led to the severe inflammatory phase, whereas corticosteroid treatment allowed a favorable outcome.

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Section: Discussionmentioning

confidence: 99%

Case Report: Complete and Fast Recovery From Severe COVID-19 in a Pemphigus Patient Treated With Rituximab

et al. 2021

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“…In a retrospective study involving 704 ABID patients, Mahmoudi et al [ 59 ], purposed such risks would gradually decrease after the last dose of Rituximab. Uzuncakmak et al [ 60 ] also found that there is no significant correlation between the lymphocyte count and the number of Rituximab treatment courses received, indicating that the risk of COVID-19 infection is independent of the received Rituximab infusion. A multicenter study from Turkey [ 61 ] (PMID: 35243732) which enrolled 247 patients reported that none of the patients treated with Rituximab required intensive care or died of COVID-19 infection, and made a conclusion that Rituximab did not require additional safety cautions relative to other immunosuppressives.…”

Section: Rituximab or Not For Pemphigus Patients?mentioning

confidence: 99%

Pemphigus during the COVID-19 Epidemic: Infection Risk, Vaccine Responses and Management Strategies

Huang

Liang

Zhang

et al. 2022

JCM

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Pemphigus is a rare autoimmune blistering disease, involving potentially life-threatening conditions often requiring immunosuppression. Currently, the COVID-19 pandemic caused by severe acute respiratory disease coronavirus 2 (SARS-CoV-2) infection has become a global public emergency. Vaccines are the most effective defense against COVID-19 infection. However, in clinic, there are cases of new onset or flare of pemphigus following COVID-19 vaccination, where vaccines have manifested significantly desirable risk-benefit profiles for patients. Although Rituximab, as first-line therapy, may impair humoral immunity, pemphigus may not predispose to develop COVID-19 infection compared to a healthy population. Conversely, delay or interruption of immunosuppressants probably results in unfavorable clinical outcomes for disease progression. Overall, clinicians should encourage their patients to undergo the vaccination after a comprehensive assessment. The definite association between COVID-19 vaccination and pemphigus remains to be further elucidated. Herein, we provide an overview of the published studies to date on COVID-19 and pemphigus as well as the exploration of their complicated interplay. In addition, we discuss the management strategies for pemphigus patients in this special period, in an effort to more effectively establish a standard treatment paradigm for this particular patient group.

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“…The authors stated that the patient received RTX infusion 7 months before COVID‐19. 16 Another study by Mahmudi et al showed that the risk of COVID‐19 and hospitalization rate is decreased significantly with each passing month from the last RTX infusion. 17 …”

Section: Discussionmentioning

confidence: 99%

“…A study from Turkey reported only one case of mild COVID‐19 among 48 pemphigus patients treated with RTX during the last 5 years. The authors stated that the patient received RTX infusion 7 months before COVID‐19 16 . Another study by Mahmudi et al showed that the risk of COVID‐19 and hospitalization rate is decreased significantly with each passing month from the last RTX infusion 17 …”

Section: Discussionmentioning

confidence: 99%

COVID ‐19 severity and SARS‐Cov ‐2 vaccine safety in pemphigus patients

Özgen

Aksoy

Çakıcı

et al. 2022

Dermatologic Therapy

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There are safety concerns in the treatment of pemphigus patients with immunosuppressants, particularly rituximab (RTX), in times of the COVID‐19 pandemic. In the beginning, the reports were more pessimistic. However, few reports have recently pointed to manageable courses in this patient group. Therefore, we investigated the disease characteristics and demographic features of pemphigus patients in the period of the COVID‐19 pandemic. We aimed to investigate the impact of immunosuppressants on the course of COVID‐19 in pemphigus patients. Also, we tried to find out the rate of flares due to COVID‐19 and SARS‐Cov‐2 vaccines. This multicenter study included 247 patients with pemphigus from three tertiary dermatology clinics with the specialized outpatient clinic for autoimmune blistering diseases. Patients were asked standardized questions in person or via telephone calls. Also, demographic data were collected from patients' files. Two hundred forty‐four of 247 patients took the survey between August and September 2021. The data of three patients were obtained from the National Health System. We collected the data of all pemphigus patients who visited the clinics at least once in the past 3 years. Among 51 patients having COVID‐19, 40 had a non‐serious disease, whereas 11 required hospitalization. One patient died because of COVID‐19 infection. The number of patients is limited, and data depends mainly on patients' statements. RTX treatment does not require additional safety cautions than other immunosuppressives.

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Can rituximab be used in the treatment of pemphigus vulgaris during the COVID ‐19 pandemic?

Cited by 12 publications

References 16 publications

Case Report: Complete and Fast Recovery From Severe COVID-19 in a Pemphigus Patient Treated With Rituximab

Case Report: Complete and Fast Recovery From Severe COVID-19 in a Pemphigus Patient Treated With Rituximab

Pemphigus during the COVID-19 Epidemic: Infection Risk, Vaccine Responses and Management Strategies

COVID ‐19 severity and SARS‐Cov ‐2 vaccine safety in pemphigus patients

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