RESUMEN
Autoimmune bullous diseases can be intraepidermal (pemphigus group of disorders) or subepidermal (pemphigoid group of disorders). The treatment of these disorders chiefly comprises corticosteroids and immunosuppressant adjuvants like azathioprine and mycophenolate mofetil. Autoantibodies are the main mediators of these diseases. Rituximab, a chimeric anti-CD20 monoclonal antibody targeting B-cells, has emerged as an excellent treatment option for refractory pemphigus vulgaris in the last decade. Since then, many new biologics have been proposed/explored for managing autoimmune bullous diseases. These hold potential for greater efficacy and lesser adverse effects than conventional immunosuppressants. In this review, we discuss the role of various biologics in the treatment of autoimmune bullous diseases, followed by a brief discussion on the drawbacks to their use and new developments in this area.
Asunto(s)
Enfermedades Autoinmunes/tratamiento farmacológico , Enfermedades Cutáneas Vesiculoampollosas/tratamiento farmacológico , Anticuerpos Monoclonales Humanizados/uso terapéutico , Autoanticuerpos/uso terapéutico , Biosimilares Farmacéuticos/uso terapéutico , Relación Dosis-Respuesta a Droga , Inhibidores Enzimáticos/uso terapéutico , Humanos , Inmunoglobulinas Intravenosas/uso terapéutico , Omalizumab/uso terapéutico , Proteínas Tirosina Quinasas/antagonistas & inhibidores , Enfermedades Cutáneas Vesiculoampollosas/inmunología , Linfocitos T/inmunologíaRESUMEN
The introduction of biologic therapy has revolutionized the treatment of many chronic diseases, including several dermatological disorders. Biological agents promise to satisfy medical needs previously unmet by conventional medicines. Unfortunately, these agents are expensive and out of reach for the majority of patients who need them. Biosimilars are copies of the innovator biological agents and represent an important advance in the field of biological therapeutics. Although they are similar to the original biologic, differences in terms of structure, efficacy, safety and immunogenicity remain a concern. Thus, biosimilars cannot be regarded as bio-generics. Awareness of the key differences between a biosimilar and its reference biological agent is essential for optimal treatment and safety of patients. The increasing availability of biosimilars provides patients and doctors with less expensive alternatives and increases the accessibility of biologic therapy to needy patients. In this review, we discuss the concept of biosimilars, the need for appropriate regulatory pathways and their current status in dermatology.