Biological treatment for bullous pemphigoid

Frontiers in Immunology

Immunology

Baruch Kaplan¹  Meital Oren-Shabtai²  Daniel Mimouni²  Adi Nosrati²  Lihi Atzmony²  Sharon Baum³  Aviv Barzilai³ 

[1] Adelson School of Medicine, Ariel University, Ariel, Israel;Division of Dermatology, Rabin Medical Center, Petah Tikva, Israel;Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel;Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel;Department of Dermatology, Sheba Medical Center, Ramat Gan, Israel;

关键词: bullous pemphigoid;    autoimmune subepidermal bullous disease;    rituximab;    dupilumab;    omalizumab;    corticosteroids;    steroid-sparing immunomodulatory agents;   

DOI  :  10.3389/fimmu.2023.1157250

 received in 2023-02-02, accepted in 2023-04-11,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundBullous pemphigoid (BP) is the most common autoimmune subepidermal bullous disease. Topical or systemic corticosteroids are often used as the first-line treatment. However, long-term corticosteroid use may lead to significant side effects. Therefore, various adjuvant immunosuppressant therapies are used as steroid-sparing agents, with accumulating reports of biological treatments for severely recalcitrant BP.ObjectiveTo describe the clinical and immunological features of a series of patients with recalcitrant BP treated with immunobiological therapies. To assess the efficacy and safety of their therapies.MethodsPatients receiving biological treatment for BP from two centers were assessed. Here, we described the clinical, immunopathological, and immunofluorescence findings of adult patients with BP and analyzed the clinical response and adverse events associated with various biological therapies.ResultsWe identified nine eligible patients treated with rituximab (seven), omalizumab (three), or dupilumab (one). The mean age at diagnosis was 60.4 years, the average BP duration before biologic initiation was 1.9 years, and the average previous treatment failure was 2.11 therapies. The mean follow-up period from the first biological treatment to the last visit was 29.3 months. Satisfactory response, defined as clinical improvement, was achieved in 78% (7) of the patients, and total BP clearance was achieved in 55% (5) of the patients at the last follow-up visit. Additional rituximab courses improved the disease outcomes. No adverse events were reported.ConclusionsEfficient and safe novel therapies can be considered in recalcitrant steroid-dependent BP non-responsive to conventional immunosuppressant therapies.

【 授权许可】

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Copyright © 2023 Oren-Shabtai, Mimouni, Nosrati, Atzmony, Kaplan, Barzilai and Baum