Shahidi-Dadras Mohammad; Kheradmand Zohreh; Abdollahimajd Fahimeh
Abstract
Background: Recently, rituximab has been successfully used for the treatment of pemphigus family, the main subtype of which is pemphigus vulgaris (PV). The aim of this study was to determine the efficacy and safety of rituximab in refractory PV. Methods: In an observational study extending from November ...
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Background: Recently, rituximab has been successfully used for the treatment of pemphigus family, the main subtype of which is pemphigus vulgaris (PV). The aim of this study was to determine the efficacy and safety of rituximab in refractory PV. Methods: In an observational study extending from November 2014 to February 2016, 30 patients with refractory PV were treated with rituximab. Response to therapy, duration of clinical remission, relapse rate, serology, and side effects of treatment with rituximab were evaluated. Results: At the end of the follow-up with a mean duration of 7.6 (6-14) months, 25 (83.3%) patients achieved complete remission with or without systemic therapy. The mean duration of disease control was 2.8 months. In all patients, the serum levels of antidesmoglein 1 and 3 IgG antibodies were reduced after rituximab therapy. In 23.4% of the patients, a clinical relapse occurred at a mean of 9.6 months following the initiation of the treatment. Infusion-related reactions occurred in 18 (60%) patients. The lack of a control group, concomitant use of corticosteroid and immunosuppressive agents, and a limited follow-up period were among the limitations of our research. Conclusions: Rituximab is a good treatment modality for refractory PV, which extends the mean time to relapse in patients. To further extend our knowledge on the efficacy and safety of rituximab therapy, more randomized controlled trials with larger sample sizes and prolonged follow-up durations are required.
Farhad Handjani; Nasrin Saki; Motahareh Hosseini; Taraneh Tadayon
Volume 20, Issue 3 , 2017, , Pages 84-88
Abstract
Background: Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are 2 inflammatory indicators that increase in many pathologic and physiologic conditions. Pemphigus vulgaris (PV) is an autoimmune skin disease in which autoantibodies against desmogleins cause acantholysis. In this study ...
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Background: Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are 2 inflammatory indicators that increase in many pathologic and physiologic conditions. Pemphigus vulgaris (PV) is an autoimmune skin disease in which autoantibodies against desmogleins cause acantholysis. In this study we have measured ESR and CRP levels in patients with PV to evaluate the relationship between an increase in these markers and disease severity.Methods: In this cross-sectional study, we selected patients with proven diagnosis of PV who referred to the Dermatology referral clinic, Faghihi hospital, Shiraz, Iran during a one year period. There were 30 patients enrolled in this study who provided blood samples to measure their ESR and CRP levels. We usedthe Mahajan scoring system to determine the disease severity. Results: In 27 (90%) cases, ESR was normal and 20 (66.7%) cases had negative CRP. There was a significant correlation between CRP and PV severity (P=0.015); however, there was no correlation between ESR and disease severity (P=0.126). Conclusion: A correlation existed between CRP and severity of PV. Further studies must be undertaken to prove the prognostic role of CRP in PV. The discovery of new prognostic factors can change the treatment strategy and protocol for PV.