Comparison Between Intravenous Immunoglobulin and Conventional Immunosuppressive Therapy Regimens in Patients With Severe Oral Pemphigoid

Ahmed, A. Razzaque; Colón, José E.

doi:10.1001/archderm.137.9.1181

Cited by 65 publications

(56 citation statements)

References 31 publications

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“…These data are presented in Table 3. We previously reported the use of IVIg therapy in bullous pemphigoid and cicatricial pemphigoid limited only to the oral cavity or ocular mucosae (7,12,20,(23)(24)(25). In this study, all 15 patients had multiple mucosal involvement.…”

Section: Discussionmentioning

confidence: 68%

“…We have also provided the response to IVIg therapy and a long-term follow-up after patients had achieved a sustained remission. Patients in this report were not presented in our earlier studies on the use of IVIg in the treatment of ocular or oral pemphigoid (7,12).…”

Section: Introductionmentioning

confidence: 98%

“…However, the prolonged usage of immunosuppressive agents has resulted in patients developing multiple side effects to these treatments (1). Intravenous immunoglobulin (IVIg) therapy has been previously reported to be a reasonable and safe alternative in the treatment of MMP localized to ocular or oral mucosa (7,12).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Intravenous Immunoglobulin Therapy in Patients with Multiple Mucosal Involvement in Mucous Membrane Pemphigoid

Sami

Bhol

Ahmed

2002

Clinical Immunology

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Section: Discussionmentioning

confidence: 68%

Section: Introductionmentioning

confidence: 98%

See 1 more Smart Citation

Intravenous Immunoglobulin Therapy in Patients with Multiple Mucosal Involvement in Mucous Membrane Pemphigoid

Sami

Bhol

Ahmed

2002

Clinical Immunology

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“…1,[5][6][7] However, patients with severe involvement or those responding poorly to the usual treatments require alternative systemic immunosuppressive/ immunomodulatory therapies, for example, systemic corticosteroids, cyclophosphamide, cyclosporine, and/or intravenous immunoglobulins (IVIg). 1,6,[8][9][10][11][12][13][14] But MMP is sometimes refractory to appropriately administered single or combined immunosuppressive regimens. In addition, the latter can induce serious adverse effects, most of which being severe infectious complications.…”

mentioning

confidence: 99%

Rituximab for Patients With Refractory Mucous Membrane Pemphigoid

Roux–Villet¹,

Prost-Squarcioni²,

Alexandre³

et al. 2011

Arch Dermatol

129

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Background: Mucous membrane pemphigoid (MMP) still represents a potentially life-and sight-threatening disease. In a subset of patients with severe MMP, conventional immunosuppressants are ineffective or contraindicated.Observations: Twenty-five patients with severe refractory MMP, including 5 with mucous membranedominant epidermolysis bullosa acquisita, received 1 or 2 cycles of rituximab (375 mg/m 2 weekly for 4 weeks). Twenty-one of the patients were receiving concomitant therapy with dapsone and/or sulfasalazine therapy, which was maintained during rituximab cycles. Complete responses in all affected sites (ocular and/or extraocular) were obtained in 17 patients (68%) by a median time of 12 weeks after the first cycle, and 5 additional patients responded completely after a second cycle, yielding an 88% complete response rate. In all but 1 of the 10 patients with ocular lesions, their eyes became noninflammatory within a mean of 10 weeks. Among the 3 patients (12%) who developed severe infectious complications, 2 (8%) died; they had been receiving concomitant conventional immunosuppressants and high-dose corticosteroids and were hypogammaglobulinemic. Treatment with immunosuppressants was discontinued for all other patients, and no other infection was observed. Ten patients experienced relapse after a mean of 4 (range, 1-16) months after achieving complete responses.Conclusions: Rituximab appears to have rapid and dramatic efficacy in patients with severe, refractory MMP. The occurrence of severe infections in patients receiving concomitant conventional immunosuppressants supports using rituximab without other immunosuppressants. Controlled prospective studies are warranted to define an optimal treatment protocol.

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“…1 For more severe cases, including those with ocular, laryngeal, pharyngeal, or esophageal involvement; those with more widespread involvement; or for those recalcitrant to previous therapies, systemic antiinflammatory or immunosuppressive medications have been used. 1 Some of these systemic medications include corticosteroids, 5 dapsone, 6,7 cyclophosphamide, 8 mycophenolate mofetil hydrochloride, 9 intravenous immunoglobulin, 10,11 azathioprine sodium, mitomycin C, 5 interferon alfa-2b, 12 and methotrexate. 13 The response of MMP to these treatment modalities has been variable.…”

mentioning

confidence: 99%

Successful Treatment of Mucous Membrane Pemphigoid With Etanercept in 3 Patients

Canizares

Smith²,

Conners³

et al. 2006

Arch Dermatol

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Comparison Between Intravenous Immunoglobulin and Conventional Immunosuppressive Therapy Regimens in Patients With Severe Oral Pemphigoid

Cited by 65 publications

References 31 publications

Intravenous Immunoglobulin Therapy in Patients with Multiple Mucosal Involvement in Mucous Membrane Pemphigoid

Intravenous Immunoglobulin Therapy in Patients with Multiple Mucosal Involvement in Mucous Membrane Pemphigoid

Rituximab for Patients With Refractory Mucous Membrane Pemphigoid

Successful Treatment of Mucous Membrane Pemphigoid With Etanercept in 3 Patients

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