Rituximab therapy in patients with bullous pemphigoid: A retrospective study of 20 patients

Background Bullous pemphigoid (BP) is the most common autoimmune blistering disease requiring treatment with immunosuppressive medications; however, finding a therapy that has a sustained durable response and an acceptable side effect profile has been challenging. Objective Our study aimed to evaluate the clinical outcomes of patients with BP treated with rituximab therapy at a single academic center. Methods A retrospective chart review was performed on 20 patients who received at least 1 dose of rituximab therapy, either as initial therapy for severe BP or as therapy for recalcitrant disease after having failed conventional immunotherapies. Results Within our cohort, 75% of patients (n = 15) achieved remission an average of 169 days following rituximab therapy. There were no rituximab-related deaths and significantly fewer adverse events following rituximab therapy. Limitations This study was limited by its retrospective nature, focus on a single academic center, and small sample size. Conclusion Use of rituximab therapy demonstrated high rates of remission, steroid-sparing activity, and an acceptable safety profile in our cohort of patients with severe BP or disease refractory to conventional therapies. Bullous pemphigoid (BP) is the most common autoimmune blistering disease requiring treatment with immunosuppressive medications; however, finding a therapy that has a sustained durable response and an acceptable side effect profile has been challenging. Our study aimed to evaluate the clinical outcomes of patients with BP treated with rituximab therapy at a single academic center. A retrospective chart review was performed on 20 patients who received at least 1 dose of rituximab therapy, either as initial therapy for severe BP or as therapy for recalcitrant disease after having failed conventional immunotherapies. Within our cohort, 75% of patients (n = 15) achieved remission an average of 169 days following rituximab therapy. There were no rituximab-related deaths and significantly fewer adverse events following rituximab therapy. This study was limited by its retrospective nature, focus on a single academic center, and small sample size. Use of rituximab therapy demonstrated high rates of remission, steroid-sparing activity, and an acceptable safety profile in our cohort of patients with severe BP or disease refractory to conventional therapies.