Effectiveness of rituximab in the treatment of patients with pemphigus vulgarus

Abstract

Pemphigus vulgaris (PV) is an autoimmune disease that affects the mucous membranes and/or skin, characterized by the formation of bubbles of various sizes with a thin flaccid cap and serous contents. Lack of timely treatment can lead to death. Due to the fact that in the Russian Federation the main method of treatment for CAP is the prescription of systemic glucocorticosteroid drugs, which cause a large number of side effects, studies confirming the effectiveness and safety of the use of rituximab in combination with systemic glucocorticosteroid (GCS) are of particular interest. Rituximab is a genetically engineered monoclonal antibody to the CD20 antigen. The mechanism of action is due to the binding of the antibody to the CD20 antigen on B-lymphocytes and the initiation of immunological reactions that mediate the lysis of B-cells, that leads to the elimination of circulating desmoglein-specific IgG(+) B-lymphocytes and contributes to the high effectiveness of rituximab in the treatment of pemphigus. In the treatment PV including rituximab and systemic corticosteroids there is a chance of possible faster reduction of corticosteroids in the daily dose, followed by their complete withdrawal after 3–6 months, that reduces the risk of serious complications developing.

Keywords

• pemphigus vulgaris
• rituximab
• bubble
• igg
• glucocorticosteroids
• case report