Biologics in autoimmune bullous diseases: Current scenario

Indian J Dermatol Venereol Leprol. 2021 Sep-Oct;87(5):611-620. doi: 10.25259/IJDVL_886_19.

Abstract

Autoimmune bullous diseases can be intraepidermal (pemphigus group of disorders) or subepidermal (pemphigoid group of disorders). The treatment of these disorders chiefly comprises corticosteroids and immunosuppressant adjuvants like azathioprine and mycophenolate mofetil. Autoantibodies are the main mediators of these diseases. Rituximab, a chimeric anti-CD20 monoclonal antibody targeting B-cells, has emerged as an excellent treatment option for refractory pemphigus vulgaris in the last decade. Since then, many new biologics have been proposed/explored for managing autoimmune bullous diseases. These hold potential for greater efficacy and lesser adverse effects than conventional immunosuppressants. In this review, we discuss the role of various biologics in the treatment of autoimmune bullous diseases, followed by a brief discussion on the drawbacks to their use and new developments in this area.

Keywords: Autoimmune bullous diseases; biologics; future perspectives; pemphigoid; pemphigus.

Publication types

  • Review

MeSH terms

  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Autoantibodies / therapeutic use
  • Autoimmune Diseases / drug therapy*
  • Biosimilar Pharmaceuticals / therapeutic use
  • Dose-Response Relationship, Drug
  • Enzyme Inhibitors / therapeutic use
  • Humans
  • Immunoglobulins, Intravenous / therapeutic use
  • Omalizumab / therapeutic use
  • Protein-Tyrosine Kinases / antagonists & inhibitors
  • Skin Diseases, Vesiculobullous / drug therapy*
  • Skin Diseases, Vesiculobullous / immunology
  • T-Lymphocytes / immunology

Substances

  • Antibodies, Monoclonal, Humanized
  • Autoantibodies
  • Biosimilar Pharmaceuticals
  • Enzyme Inhibitors
  • Immunoglobulins, Intravenous
  • Omalizumab
  • dupilumab
  • mepolizumab
  • efgartigimod alfa
  • Protein-Tyrosine Kinases