Treatment Update of Autoimmune Blistering Diseases

Khalaf Kridin; Christine Ahn; William C Huang; Ahmed Ansari; Naveed Sami

doi:10.1016/j.det.2018.12.003

Treatment Update of Autoimmune Blistering Diseases

Dermatol Clin. 2019 Apr;37(2):215-228. doi: 10.1016/j.det.2018.12.003. Epub 2019 Feb 14.

Authors

Khalaf Kridin¹, Christine Ahn², William C Huang², Ahmed Ansari³, Naveed Sami⁴

Affiliations

¹ Department of Dermatology, Rambam Health Care Campus, POB 9602, Haifa 31096, Israel.
² Department of Dermatology, Wake Forest School of Medicine, Wake Forest University, 4618 Country Club Road, Winston-Salem, NC 27104, USA.
³ College of Medicine (Lake Nona), University of Central Florida, 6850 Lake Nona Boulevard, Orlando, FL 32827, USA.
⁴ Department of Medicine, University of Central Florida, Health Sciences Campus at Lake Nona, 2627 Northampton Avenue, Orlando, FL 32827-7408, USA. Electronic address: naveed.sami@ucf.edu.

PMID: 30850044
DOI: 10.1016/j.det.2018.12.003

Abstract

The treatment of refractory autoimmune blistering diseases (AIBDs) has always been a challenge. Because randomized controlled trials are lacking, treatment has been based on analysis of anecdotal data. The last 2 decades has seen the use of rituximab become a conventional treatment in the therapeutic armamentarium of AIBDs, leading to its Food and Drug Administration indication for pemphigus vulgaris in 2018. We review the current updated data on the use of rituximab including dosing, protocols, and its role in the algorithm of AIBDs. In addition, we discuss several promising novel emerging therapeutic agents for AIBDs.

Keywords: Autoimmune blistering diseases; Emerging; Rituximab; Treatment.

Publication types

Review

MeSH terms

Agammaglobulinaemia Tyrosine Kinase / antagonists & inhibitors
Antibodies, Monoclonal / therapeutic use
Antibodies, Monoclonal, Humanized / therapeutic use
Autoimmune Diseases / immunology
Autoimmune Diseases / therapy*
Dermatitis Herpetiformis / immunology
Dermatitis Herpetiformis / therapy
Epidermolysis Bullosa Acquisita / immunology
Epidermolysis Bullosa Acquisita / therapy
Female
Glucocorticoids / therapeutic use
Humans
Immunoglobulins, Intravenous / therapeutic use
Immunologic Factors / therapeutic use
Immunosuppressive Agents / therapeutic use*
Immunotherapy, Adoptive*
Pemphigoid Gestationis / immunology
Pemphigoid Gestationis / therapy
Pemphigoid, Benign Mucous Membrane / immunology
Pemphigoid, Benign Mucous Membrane / therapy
Pemphigoid, Bullous / immunology
Pemphigoid, Bullous / therapy
Pemphigus / immunology
Pemphigus / therapy
Plasmapheresis*
Pregnancy
Protein Kinase Inhibitors / therapeutic use*
Rituximab / therapeutic use
Skin Diseases, Vesiculobullous / immunology
Skin Diseases, Vesiculobullous / therapy*
p38 Mitogen-Activated Protein Kinases / antagonists & inhibitors

Substances

Antibodies, Monoclonal
Antibodies, Monoclonal, Humanized
Glucocorticoids
Immunoglobulins, Intravenous
Immunologic Factors
Immunosuppressive Agents
Protein Kinase Inhibitors
Rituximab
ocrelizumab
veltuzumab
Agammaglobulinaemia Tyrosine Kinase
BTK protein, human
p38 Mitogen-Activated Protein Kinases
ofatumumab
obinutuzumab