Document Detail

Where does rituximab fit in the treatment of autoimmune mucocutaneous blistering skin disease?
MedLine Citation:
PMID:  22527431     Owner:  NLM     Status:  MEDLINE    
We propose rituximab as a first-line therapy for pemphigus vulgaris and steroid-dependent bullous pemphigoid with or without systemic steroids. A brief review of the literature substantiates the significant risk associated with the use of long term, high-dose prednisone, mycophenolate mofetil (MMF), and azathioprine. No head-to-head studies are available with respect to safety and efficacy of rituximab versus these therapies. When comparing the side effects of rituximab to MMF, both are found to be mild when used as monotherapy in dermatologic patients. The most severe side effects of rituximab include fatal infusion reactions and hypersensitivity, pancytopenia, infection and organ dysfunction. With MMF, malignancy, pancytopenia, infection, and organ dysfunction are the most concerning side effects. The frequencies of these observed adverse events are difficult to compare, but the side effect profiles of rituximab and MMF are clearly similar. Therefore, there is equipoise whether to use rituximab before rather than after MMF and/or systemic corticosteroids.
Rishi Nigam; Jacob Levitt
Publication Detail:
Type:  Comparative Study; Journal Article; Review    
Journal Detail:
Title:  Journal of drugs in dermatology : JDD     Volume:  11     ISSN:  1545-9616     ISO Abbreviation:  J Drugs Dermatol     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-04-24     Completed Date:  2012-08-15     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  101160020     Medline TA:  J Drugs Dermatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  622-5     Citation Subset:  IM    
Karolinska Institute, Stockholm, Sweden.
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MeSH Terms
Antibodies, Monoclonal, Murine-Derived / adverse effects,  therapeutic use*
Azathioprine / adverse effects,  therapeutic use
Glucocorticoids / adverse effects,  therapeutic use
Immunologic Factors / adverse effects,  therapeutic use*
Immunosuppressive Agents / adverse effects,  therapeutic use
Mycophenolic Acid / adverse effects,  analogs & derivatives,  therapeutic use
Pemphigoid, Bullous / drug therapy*,  pathology
Prednisone / adverse effects,  therapeutic use
Reg. No./Substance:
0/Antibodies, Monoclonal, Murine-Derived; 0/Glucocorticoids; 0/Immunologic Factors; 0/Immunosuppressive Agents; 0/rituximab; 24280-93-1/Mycophenolic Acid; 446-86-6/Azathioprine; 53-03-2/Prednisone; 9242ECW6R0/mycophenolate mofetil

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