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

Authors


  • §

    Consensus meeting (organization:M.H.and D.Z.) on March 4,2006 concerning the use of rituximab in autoimmune bullous skin disorders; with the kind support of Roche Pharma AG,Grenzach-Wyhlen,Germany.


Prof. Dr. M. Hertl
Klinik für Dermatologie und
Allergologie
Universitätsklinikum Gießen und
Marburg GmbH, Standort Marburg
Deutschhausstraße 9
D-35037 Marburg
E-mail: hertl@med.uni-marburg.de
Prof. Dr. D. Zillikens
Klinik für Dermatologie, Allergologie
und Venerologie
Universität zu Lübeck
Ratzeburger Allee 160
D-23538 Lübeck
E-mail: detlef.zillikens@uk-sh.de

Summary

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/m2 i.v.in weekly intervals for four consecutive weeks in addition to the standard immunosuppressive treatment.The present consensus statement of German-speaking derma-tologists,rheumatologists and oncologists summarizes and evaluates the current evidence for the use and mode of application of rituximab in autoimmune bullous skin disorders.

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