Efficacy of Rituximab in the treatment of pemphigus: experience of Moroccan population

Abstract

Background: Pemphigus is a severe autoimmune blistering disease mediated 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 vulgaris and superficial pemphigus has been progressively growing with increasing evidence of successful outcomes. Material and Methods: It was a prospective study extending for two years in the dermatology department of the UHC Hassan II in Fez, dealing with patients with pemphigus who are severe or resistant to conventional treatments treated with Rituximab. We analyzed the efficacy and tolerance of Rituximab in the treatment of severe and refractory forms of our pemphigus population. Results: Patients treated by Rituximab were 13. Eleven cases of pemphigus vulgaris and two cases of superficial pemphigus In our series, Rituximab was used with satisfactory, indeed, 6 patients achieved complete remission, while 4 had partial remission. Side effects of Rituximab were infectious complications. Conclusions: We highlight the efficiency and safety of Rituximab in our series.

Comparative Study Between Two Protocols of Rituximab in Pemphigus: About 63 Cases

“…Leshem, et al, used the rheumatoid arthritis protocol of rituximab infusion in 47 pemphigus patients. The relapse rate was 22%, which is similar to our study's (22.78%) [12]. According to Zakka, et al, the rate of infections was lower in the lymphoma protocol compared to the PR protocol [13,14].…”

Pemphigus vulgaris

“…A suprabasal cleft with intraepithelial acantholysis is revealed on histopathology. The disease is treated with steroids, immunosuppressive and biological agents [1][2][3]. 45years old man presented with painful oral ulcerations and crusted lesions of the trunk for 2 years.…”