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The use of rituximab as an adjuvant in the treatment of oral pemphigus vulgaris.
J Oral Pathol Med. 2020 Jan; 49(1):91-95.JO

Abstract

BACKGROUND

Pemphigus vulgaris patients with exclusive oral involvement (OPV) treated with conventional immunosuppressive therapy may be non-responders or experience severe side effects and/or relapses. In such cases, rituximab could be used as an adjuvant in recalcitrant OPV patients.

METHODS

A retrospective single-center study on patients with oral pemphigus vulgaris treated with RTX at a dose of 375 mg/m2 was performed, evaluating the complete clinical and immunological remission, side effects of RTX, and possible correlation between anti-desmoglein (Dsg) 3 antibodies and clinical remission.

RESULTS

We treated 10 OPV patients, of which 60% had a moderate and 40% mild disease severity before therapy with RTX. Complete clinical remission (CCR) was achieved in 100% of OPV patients, of which 20% developed side effects and 20% experienced a relapse in a mean time of 15.2 ± 10.2 weeks. The mean time for CCR was achieved in 19.8 ± 10.3 weeks, whereas the duration of the CCR consisted in 37.4 ± 33.5 weeks. OPV patients underwent a mean follow-up of 57.2 ± 37.7 weeks. In all patients, the mean of pemphigus disease area index (PDAI) decreased from 20.3 ± 14.1 to 0.4 ± 0.0, whereas the mean Dsg3 value dropped from 157.1 ± 40.6 to 67.0 ± 26.6 after therapy with RTX. However, no correlation was found between PDAI and anti-Dsg3 antibodies before and after therapy with RTX (P > .05).

CONCLUSIONS

RTX represents a valid and safe alternative as an adjuvant in OPV patients with low rate of relapses and side effects.

Authors+Show Affiliations

Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, Naples, Italy. D.eb.RA. Mexico Foundation, Guadalupe N.L., Monterrey, Mexico. Federico Navarro Institute - School of Orgonomy "Piero Borrelli", Naples, Italy.Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, Naples, Italy.Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, Naples, Italy.Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, Naples, Italy.Department of Economics and Statistics, Federico II University of Naples, Naples, Italy.Department of Medicine, Surgery and Dentistry, University of Salerno, Fisciano, Italy.Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, Naples, Italy.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31420993

Citation

Fortuna, Giulio, et al. "The Use of Rituximab as an Adjuvant in the Treatment of Oral Pemphigus Vulgaris." Journal of Oral Pathology & Medicine : Official Publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology, vol. 49, no. 1, 2020, pp. 91-95.
Fortuna G, Calabria E, Ruoppo E, et al. The use of rituximab as an adjuvant in the treatment of oral pemphigus vulgaris. J Oral Pathol Med. 2020;49(1):91-95.
Fortuna, G., Calabria, E., Ruoppo, E., Adamo, D., Aria, M., Amato, M., & Mignogna, M. D. (2020). The use of rituximab as an adjuvant in the treatment of oral pemphigus vulgaris. Journal of Oral Pathology & Medicine : Official Publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology, 49(1), 91-95. https://doi.org/10.1111/jop.12951
Fortuna G, et al. The Use of Rituximab as an Adjuvant in the Treatment of Oral Pemphigus Vulgaris. J Oral Pathol Med. 2020;49(1):91-95. PubMed PMID: 31420993.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The use of rituximab as an adjuvant in the treatment of oral pemphigus vulgaris. AU - Fortuna,Giulio, AU - Calabria,Elena, AU - Ruoppo,Elvira, AU - Adamo,Daniela, AU - Aria,Massimo, AU - Amato,Massimo, AU - Mignogna,Michele D, Y1 - 2019/09/06/ PY - 2019/05/28/received PY - 2019/08/06/revised PY - 2019/08/13/accepted PY - 2019/8/20/pubmed PY - 2020/1/31/medline PY - 2019/8/18/entrez KW - OPV KW - desmoglein KW - disease severity KW - oral pemphigus vulgaris KW - remission KW - rituximab SP - 91 EP - 95 JF - Journal of oral pathology & medicine : official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology JO - J Oral Pathol Med VL - 49 IS - 1 N2 - BACKGROUND: Pemphigus vulgaris patients with exclusive oral involvement (OPV) treated with conventional immunosuppressive therapy may be non-responders or experience severe side effects and/or relapses. In such cases, rituximab could be used as an adjuvant in recalcitrant OPV patients. METHODS: A retrospective single-center study on patients with oral pemphigus vulgaris treated with RTX at a dose of 375 mg/m2 was performed, evaluating the complete clinical and immunological remission, side effects of RTX, and possible correlation between anti-desmoglein (Dsg) 3 antibodies and clinical remission. RESULTS: We treated 10 OPV patients, of which 60% had a moderate and 40% mild disease severity before therapy with RTX. Complete clinical remission (CCR) was achieved in 100% of OPV patients, of which 20% developed side effects and 20% experienced a relapse in a mean time of 15.2 ± 10.2 weeks. The mean time for CCR was achieved in 19.8 ± 10.3 weeks, whereas the duration of the CCR consisted in 37.4 ± 33.5 weeks. OPV patients underwent a mean follow-up of 57.2 ± 37.7 weeks. In all patients, the mean of pemphigus disease area index (PDAI) decreased from 20.3 ± 14.1 to 0.4 ± 0.0, whereas the mean Dsg3 value dropped from 157.1 ± 40.6 to 67.0 ± 26.6 after therapy with RTX. However, no correlation was found between PDAI and anti-Dsg3 antibodies before and after therapy with RTX (P > .05). CONCLUSIONS: RTX represents a valid and safe alternative as an adjuvant in OPV patients with low rate of relapses and side effects. SN - 1600-0714 UR - https://www.unboundmedicine.com/medline/citation/31420993/The_use_of_rituximab_as_an_adjuvant_in_the_treatment_of_oral_pemphigus_vulgaris_ L2 - https://doi.org/10.1111/jop.12951 DB - PRIME DP - Unbound Medicine ER -