Recommendations for the use of rituximab (anti-CD20 antibody) in the treatment of autoimmune bullous skin diseases

J Dtsch Dermatol Ges. 2008 May;6(5):366-73. doi: 10.1111/j.1610-0387.2007.06602.x. Epub 2008 Jan 14.
[Article in English, German]

Abstract

Autoimmune bullous skin disorders are induced by autoantibodies against distinct adhesion complexes of the epidermal and dermal-epidermal junction. Since most of these disorders are characterized by a severe, potentially lethal course,they require long-term immunosuppressive treatment to reduce the de novo synthesis of pathogenic autoantibodies by B lymphocytes. Rituximab, a chimeric monoclonal antibody against CD20 on B lymphocytes, has shown promise in several case reports or cohort studies in the treatment of paraneo-plastic pemphigus,refractory cases of pemphigus vulgaris and foliaceus and in other autoimmune bullous disorders. Treatment with rituximab leads to depletion of pathogenic B-cells which may last up to 12 months resulting in a reduction of plasma cells secreting pathogenic autoantibodies. Rituximab is usually administered in an adjuvant setting at a dose of 375 mg/m(2) i.v.in weekly intervals for four consecutive weeks in addition to the standard immunosuppressive treatment. The present consensus statement of German-speaking dermatologists, rheumatologists and oncologists summarizes and evaluates the current evidence for the use and mode of application of rituximab in autoimmune bullous skin disorders.

Publication types

  • Consensus Development Conference

MeSH terms

  • Antibodies, Monoclonal / administration & dosage*
  • Antibodies, Monoclonal, Murine-Derived
  • Autoimmune Diseases / drug therapy*
  • Dermatology / standards*
  • Drug Administration Schedule
  • Humans
  • Practice Guidelines as Topic*
  • Rituximab
  • Skin Diseases, Vesiculobullous / drug therapy*

Substances

  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Murine-Derived
  • Rituximab