Aktuelle Therapie des PemphigusTherapy of pemphigus

Translated title of the contribution: Therapy of pemphigus

N van Beek, D Zillikens, E Schmidt

Abstract

BACKGROUND: Pemphigus diseases are a heterogeneous group of potentially life-threatening autoimmune bullous disorders. Therefore, rapidly acting and effective therapeutic approaches are essential.

OBJECTIVES: In this review, current therapeutic options in line with available guidelines are presented and new therapeutic approaches are discussed.

METHODS: A literature search was performed using PubMed.

RESULTS: Treatment of pemphigus is based on systemic glucocorticosteroids, frequently combined with potentially corticosteroid-sparing immunosuppressants such as azathioprine and mycophenolate mofetil/mycophenolic acid. Recently, the impressive efficacy of the anti-CD20 antibody rituximab has been shown in a prospective randomized trial. In severe or treatment-refractory cases, immunoadsorption or high-dose intravenous immunoglobulins (IVIG) are recommended. Adjuvant immunoadsorption also seems to be useful within the first 8-12 weeks of therapy in patients with very high autoantibody levels. A variety of new therapeutic approaches is currently evaluated in phase IIa studies.

CONCLUSION: Therapy of pemphigus has been greatly improved by the employment of rituximab. The use of glucocorticosteroids, associated with a high number of adverse events and elevated mortality, could be reduced by the additional use of rituximab. After approval of rituximab for the treatment of pemphigus by the US Food and Drug Administration in 2018, licensing in Europe is expected in 2019.

Translated title of the contributionTherapy of pemphigus
Original languageGerman
JournalHautarzt
Volume70
Issue number4
Pages (from-to)243-253
Number of pages11
ISSN0017-8470
DOIs
Publication statusPublished - 04.2019

Research Areas and Centers

  • Academic Focus: Center for Infection and Inflammation Research (ZIEL)

DFG Research Classification Scheme

  • 205-19 Dermatology

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