Archives of Dermatological Research

, Volume 306, Issue 1, pp 67–74

A prospective study on clinical response and cell-mediated immunity of pemphigus patients treated with rituximab

  • Y. A. Leshem
  • M. David
  • E. Hodak
  • D. A. Waitman
  • D. Vardy
  • M. Israeli
  • M. Eskin-Schwartz
  • R. Bergman
  • D. Mimouni
Original Paper

DOI: 10.1007/s00403-013-1355-4

Cite this article as:
Leshem, Y.A., David, M., Hodak, E. et al. Arch Dermatol Res (2014) 306: 67. doi:10.1007/s00403-013-1355-4

Abstract

Rituximab has recently been reported in retrospective studies to be effective in pemphigus at the dosing schedule used for treating rheumatoid arthritis (RA) of two 1,000 mg infusions 2 weeks apart. While the effect of rituximab on B cells has been well described, its effect on global T cell function has not been assessed. Ten patients who received RA dosage rituximab were prospectively assessed for clinical response. Immunological response including autoantibody titers, CD20+ B cell, and CD4+ T cell counts was assessed pre- and post-treatment. The CD4+ T cell function was determined by a novel assay measuring intracellular ATP levels in response to mitogenic stimulus. At 6 months, 90 % of patients achieved remission. Disease control and remission were achieved at median times of 1 and 3.7 months, respectively. There was a 67 % relapse rate during an average follow-up of 22 months. Global CD4+ T cell numbers and function were preserved 3 months after rituximab. A single cycle of RA dosage rituximab with concomitant immunosuppression is effective in pemphigus. We did not find an effect on total CD4+ T cell numbers or function 3 months after treatment.

Keywords

PemphigusRituximabMabTheraCylexImmuKnow

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Y. A. Leshem
    • 1
    • 2
  • M. David
    • 1
    • 2
  • E. Hodak
    • 1
    • 2
  • D. A. Waitman
    • 3
  • D. Vardy
    • 3
    • 4
  • M. Israeli
    • 5
  • M. Eskin-Schwartz
    • 1
  • R. Bergman
    • 6
    • 7
  • D. Mimouni
    • 1
    • 2
  1. 1.Department of DermatologyRabin Medical Center, Beilinson HospitalPetach TikvaIsrael
  2. 2.Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael
  3. 3.Medical DivisionLeumit Health ServicesTel-AvivIsrael
  4. 4.Faculty of Health SciencesBen-Gurion University of the NegevBeer-ShevaIsrael
  5. 5.Tissue Typing LaboratoryRabin Medical CenterPetach TikvaIsrael
  6. 6.Department of DermatologyRambam Medical CenterHaifaIsrael
  7. 7.The Bruce Rappaport Faculty of MedicineTechnion-Israel Institute of TechnologyHaifaIsrael