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.

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