Iranian guideline for rituximab therapy in pemphigus patients
Citations Over TimeTop 10% of 2019 papers
Abstract
Pemphigus vulgaris (PV) is an autoimmune blistering disease affecting the skin and/or mucosa. Rituximab (RTX) has been approved recently by US FDA as an effective and safe treatment of PV. The high incidence of PV in Iran encouraged our team to prepare a consensus guideline for RTX administration based on literature review and a decade experience of an expert panel. RTX is recommended for the treatment of new cases of PV as well as patients not responding to conventional therapy. Contraindications include history of anaphylaxis or IgE-mediated hypersensitivity to murine proteins of RTX, severe active infections, pregnancy, breastfeeding, severe heart failure, and arrhythmia. Prophylactic antiviral therapy is recommended in patients at risk of reactivation of HBV and isoniazid for those at risk of reactivation of tuberculosis. Concomitant use of systemic corticosteroids is recommended as a rule. Except for methotrexate, the combination with other immunosuppressive drugs is discouraged. Intravenous immunoglobulin is recommended for those at risk of infections or with extensive disease. The recommended dosage of RTX for the first cycle is 2 g either 500 mg weekly or 1 g biweekly. There is no general consensus whether the next doses of RTX be administered upon relapse or as maintenance therapy. We strongly recommend RTX sooner in the course of pemphigus.
Related Papers
- → Rituximab: A monoclonal antibody to CD20 used in the treatment of pemphigus vulgaris(2006)70 cited
- → Treatment of refractory pemphigus vulgaris with anti‐CD20 monoclonal antibody (rituximab): Five cases(2007)32 cited
- → Management of pediatric pemphigus vulgaris with rituximab: A case report and review of the literature(2022)6 cited
- → Prolonged treatment with rituximab in patients with refractory pemphigus vulgaris(2007)17 cited
- → Efficacy of Repeated Courses of Rituximab as Treatment for Pemphigus Vulgaris(2020)7 cited