Rituximab a potential treatment for bullous pemphigoid
Rituximab is a potential immunosuppressive treatment for bullous pemphigoid (BP), yielding high rates of remission, good steroid-sparing activity and an acceptable safety profile, reports a recent study.
Researchers retrospectively reviewed the charts of 20 BP patients (median age at treatment, 71.2 years; 50 percent female) who had received at least one dose of rituximab. Study outcomes included clinical status, BP disease activity index (BPDAI) score and adverse events related to treatment. All patients were given topical corticosteroids to use as needed.
The 20 participants contributed to 206 visits. Seventeen patients received one rituximab course, two received two courses and one received three courses. Patients received their first rituximab dose at an average of 231 days after their first visit, and participants were followed for a mean of 508 days after rituximab treatment.
Kaplan-Meier curves showed that the median time to remission and relapse after rituximab treatment was 196 and 508 days, respectively. Majority (75 percent; n=15) of patients showed durable remission after an average of 169 days after rituximab therapy. Of these, one did not require any adjuvant medication and three were maintained on minimal medication; eight achieved partial response.
Most (60 percent; n=9) of the patients who achieved durable remission no longer required prednisone, whereas those who were still on the medication took an average dose of 7.7 mg.
There were no deaths during the study period; 23 adverse events were reported during pre-rituximab phase and 23 during the post-rituximab phase. However, normalizing to rates per person-year, the incidence rate for adverse events dropped from 1.836 before rituximab to 0.827 after.