Effect of Anti-CD20 Monoclonal Antibody (Rituximab) on Recalcitrant Pemphigus Vulgaris / 대한피부과학회지

ABSTRACT

BACKGROUND: Pemphigus is a severe blistering disorder caused by autoantibodies to desmogleins 1 and 3. Because some patients with pemphigus never enter into remission, new immunosuppressants are warranted. Rituximab is a chimeric monoclonal antibody binding to the CD20 antigen on B cells, which proved to be effective in recalcitrant pemphigus. OBJECTIVE: The purpose of this study was to evaluate the efficacy and safety of Rituximab in the treatment of refractory pemphigus vulgaris. METHODS: A retrospective analysis was conducted of six patients with recalcitrant pemphigus vulgaris in Yongdong Severance Hospital. Rituximab was administered intravenously at a dosage of 375 mg/m(2) body surface area. Five patient received 2 cycles of Rituximab treatment with an interval of 7 days. One patient received 5 cycles of treatment. The mean follow-up after treatment was 9.3 months (range, 2 months to 16 months). RESULTS: All the patients presented clinical improvements. The average pemphigus vulgaris severity score decreased from 12.2 to 2.5 after treatment. No adverse effects were observed. CONCLUSION: Rituximab has been proved as an effective and safe treatment for refractory pemphigus vulgaris.