Rituximab and low dose oral immune modulating treatment to maintain a sustained response in severe pemphigus patients
Objectives: This pilot retrospective study examined the role of continuous low-dose maintenance immunomodulatory treatment (IMT) as an adjunct to rituximab (RTX) rescue therapy in severe pemphigus vulgaris (PV) and pemphigus foliaceus (PF) after a complete response (CR) to RTX was achieved. Material...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2019-05-01
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| Series: | Journal of Dermatological Treatment |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/09546634.2018.1510173 |
| _version_ | 1797683707797045248 |
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| author | Jordan M. Keeley Stephanie L. Bevans Tarannum Jaleel Naveed Sami |
| author_facet | Jordan M. Keeley Stephanie L. Bevans Tarannum Jaleel Naveed Sami |
| author_sort | Jordan M. Keeley |
| collection | DOAJ |
| description | Objectives: This pilot retrospective study examined the role of continuous low-dose maintenance immunomodulatory treatment (IMT) as an adjunct to rituximab (RTX) rescue therapy in severe pemphigus vulgaris (PV) and pemphigus foliaceus (PF) after a complete response (CR) to RTX was achieved. Materials and methods: Ten severe pemphigus patients who received RTX rescue therapy were evaluated after achieving CR. The post-RTX clinical course and long-term follow up was compared between patients who adhered to a low recommended dose (LRMD) to patients who were non-compliant with LRMD. Results: Five patients relapsed due to discontinuing or tapering their LRMD therapy, whereas the five patients who adhered to their maintenance therapy did not experience a relapse after the initial post-RTX CR. A combination of increasing or adding IMTs and initiating subsequent RTX cycles was used to regain control in relapsed patients. Conclusions: We propose an alternative treatment strategy utilizing RTX as a rescue agent in combination with long-term LRMD as a means to maintain a sustained long-term CR post-RTX therapy in severe pemphigus patients. This strategy could prevent disease flares and the need for additional RTX cycles and higher dosages of immunomodulatory therapies. |
| first_indexed | 2024-03-12T00:19:34Z |
| format | Article |
| id | doaj.art-c632958a7a3344b7a1a594e9ebb29e9f |
| institution | Directory Open Access Journal |
| issn | 0954-6634 1471-1753 |
| language | English |
| last_indexed | 2024-03-12T00:19:34Z |
| publishDate | 2019-05-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Journal of Dermatological Treatment |
| spelling | doaj.art-c632958a7a3344b7a1a594e9ebb29e9f2023-09-15T14:08:33ZengTaylor & Francis GroupJournal of Dermatological Treatment0954-66341471-17532019-05-0130434034510.1080/09546634.2018.15101731510173Rituximab and low dose oral immune modulating treatment to maintain a sustained response in severe pemphigus patientsJordan M. Keeley0Stephanie L. Bevans1Tarannum Jaleel2Naveed Sami3University of Alabama at BirminghamUniversity of Alabama at BirminghamDuke University Medical CenterUniversity of Central FloridaObjectives: This pilot retrospective study examined the role of continuous low-dose maintenance immunomodulatory treatment (IMT) as an adjunct to rituximab (RTX) rescue therapy in severe pemphigus vulgaris (PV) and pemphigus foliaceus (PF) after a complete response (CR) to RTX was achieved. Materials and methods: Ten severe pemphigus patients who received RTX rescue therapy were evaluated after achieving CR. The post-RTX clinical course and long-term follow up was compared between patients who adhered to a low recommended dose (LRMD) to patients who were non-compliant with LRMD. Results: Five patients relapsed due to discontinuing or tapering their LRMD therapy, whereas the five patients who adhered to their maintenance therapy did not experience a relapse after the initial post-RTX CR. A combination of increasing or adding IMTs and initiating subsequent RTX cycles was used to regain control in relapsed patients. Conclusions: We propose an alternative treatment strategy utilizing RTX as a rescue agent in combination with long-term LRMD as a means to maintain a sustained long-term CR post-RTX therapy in severe pemphigus patients. This strategy could prevent disease flares and the need for additional RTX cycles and higher dosages of immunomodulatory therapies.http://dx.doi.org/10.1080/09546634.2018.1510173immunomodulatory therapypemphigus foliaceuspemphigus vulgarisrituximab |
| spellingShingle | Jordan M. Keeley Stephanie L. Bevans Tarannum Jaleel Naveed Sami Rituximab and low dose oral immune modulating treatment to maintain a sustained response in severe pemphigus patients Journal of Dermatological Treatment immunomodulatory therapy pemphigus foliaceus pemphigus vulgaris rituximab |
| title | Rituximab and low dose oral immune modulating treatment to maintain a sustained response in severe pemphigus patients |
| title_full | Rituximab and low dose oral immune modulating treatment to maintain a sustained response in severe pemphigus patients |
| title_fullStr | Rituximab and low dose oral immune modulating treatment to maintain a sustained response in severe pemphigus patients |
| title_full_unstemmed | Rituximab and low dose oral immune modulating treatment to maintain a sustained response in severe pemphigus patients |
| title_short | Rituximab and low dose oral immune modulating treatment to maintain a sustained response in severe pemphigus patients |
| title_sort | rituximab and low dose oral immune modulating treatment to maintain a sustained response in severe pemphigus patients |
| topic | immunomodulatory therapy pemphigus foliaceus pemphigus vulgaris rituximab |
| url | http://dx.doi.org/10.1080/09546634.2018.1510173 |
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