Rituximab Therapy for Mucous Membrane Pemphigoid: A Retrospective Monocentric Study With Long-Term Follow-Up in 109...

Area of Science:

• Autoimmune Blistering Diseases (AIBDs)
• Immunology
• Dermatology

Background:

• Mucous membrane pemphigoid (MMP) is a rare, chronic, subepithelial autoimmune blistering disease.
• MMP can cause sight-threatening and life-threatening complications.
• Rituximab (RTX) shows promise for severe MMP refractory to conventional treatments.

Purpose of the Study:

• To evaluate the efficacy of rituximab (RTX) in a large cohort of severe and/or refractory mucous membrane pemphigoid (MMP) patients.
• To assess RTX treatment schedules, concomitant therapies, and long-term outcomes, including remission rates and relapses.
• To compare RTX efficacy in MMP with other autoimmune blistering diseases.

Main Methods:

• Retrospective monocentric study of 109 severe/refractory MMP patients treated with RTX.
• RTX administered with immunomodulatory drugs (dapsone, salazopyrine) without other systemic immunosuppressants in most cases.
• RTX schedule: two 1g injections (2 weeks apart), repeated every 6 months until CR, with consolidation and maintenance injections.

Main Results:

• Complete remission (CR) achieved in 85.3% of patients, with a median of two RTX cycles.
• Median time to disease control and CR were 7.1 and 12.2 months, respectively.
• 68.7% achieved CR off RTX one year after treatment weaning; 22.0% achieved CR with minimal immunomodulatory drugs.

Conclusions:

• Rituximab (RTX) is a highly effective therapy for severe and/or refractory mucous membrane pemphigoid (MMP).
• The RTX regimen used, combined with immunomodulatory drugs, demonstrated a favorable safety profile.
• RTX efficacy in MMP supports its role in managing autoimmune blistering diseases.