A systematic review on efficacy, safety, and treatment-durability of low-dose rituximab for the treatment of Pemphigus : special focus on COVID-19 pandemic concerns
BACKGROUND: Rituximab is a FDA-approved monoclonal antibody for adults with moderate to severe potentially life-threatening pemphigus vulgaris. Recent studies have focused on assessments of efficacy and safety of low-dose rituximab (<2 gram in each cycle).
METHOD: Databases were searched from 2010 to 2020 (last update: 1 June 2020).
RESULT: Nine studies were entered; including180 cases (92: women, 88: men, age range: 9-83 years). The dosages of each Rituximab cycle varied between ultra-low-dose (≤500 mg for a cycle, either multiple infusions or a single infusion), low-dose (2 × 375 mg/m2 or 2 × 500 mg) and modified-dose (3 × 375 mg/m2 or 3 × 500 mg). The efficacy and safety of Rituximab in the studies are known by the recovery time, relapse time, and side events. According to the studies, 2 × 500 can lead to complete remission in a broad range, from 35 to 82%. These differences might be explained by different end-points and variable cumulative corticosteroid dosage after RTX administration. Although the studies showed that low dose RTX is efficient, there are some controversies regarding the choosing low-dose for severe patients.
CONCLUSION: Considering the effectiveness of low-dose, intermediate dose, and ultra-low-dose protocols of Rituximab in inducing remission in pemphigus disease and considering factors such as cost of therapy, and the need to induce a minimum of immunosuppression for a minimum duration in the COVID-19 pandemic, suggested to use low-dose Rituximab protocol (2 infusions of 500 mg Rituximab: interval of 2 weeks) to induce the remission in mild-to-moderate pemphigus patients.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2021 |
|---|---|
| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:43 |
|---|---|
| Enthalten in: |
Immunopharmacology and immunotoxicology - 43(2021), 5 vom: 01. Okt., Seite 507-518 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Tavakolpour, Soheil [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
4F4X42SYQ6 |
|---|
| Anmerkungen: |
Date Completed 29.09.2021 Date Revised 26.04.2022 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1080/08923973.2021.1953063 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM328321877 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM328321877 | ||
| 003 | DE-627 | ||
| 005 | 20231225202710.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2021 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1080/08923973.2021.1953063 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1094.xml |
| 035 | |a (DE-627)NLM328321877 | ||
| 035 | |a (NLM)34287098 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Tavakolpour, Soheil |e verfasserin |4 aut | |
| 245 | 1 | 2 | |a A systematic review on efficacy, safety, and treatment-durability of low-dose rituximab for the treatment of Pemphigus |b special focus on COVID-19 pandemic concerns |
| 264 | 1 | |c 2021 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 29.09.2021 | ||
| 500 | |a Date Revised 26.04.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: Rituximab is a FDA-approved monoclonal antibody for adults with moderate to severe potentially life-threatening pemphigus vulgaris. Recent studies have focused on assessments of efficacy and safety of low-dose rituximab (<2 gram in each cycle) | ||
| 520 | |a METHOD: Databases were searched from 2010 to 2020 (last update: 1 June 2020) | ||
| 520 | |a RESULT: Nine studies were entered; including180 cases (92: women, 88: men, age range: 9-83 years). The dosages of each Rituximab cycle varied between ultra-low-dose (≤500 mg for a cycle, either multiple infusions or a single infusion), low-dose (2 × 375 mg/m2 or 2 × 500 mg) and modified-dose (3 × 375 mg/m2 or 3 × 500 mg). The efficacy and safety of Rituximab in the studies are known by the recovery time, relapse time, and side events. According to the studies, 2 × 500 can lead to complete remission in a broad range, from 35 to 82%. These differences might be explained by different end-points and variable cumulative corticosteroid dosage after RTX administration. Although the studies showed that low dose RTX is efficient, there are some controversies regarding the choosing low-dose for severe patients | ||
| 520 | |a CONCLUSION: Considering the effectiveness of low-dose, intermediate dose, and ultra-low-dose protocols of Rituximab in inducing remission in pemphigus disease and considering factors such as cost of therapy, and the need to induce a minimum of immunosuppression for a minimum duration in the COVID-19 pandemic, suggested to use low-dose Rituximab protocol (2 infusions of 500 mg Rituximab: interval of 2 weeks) to induce the remission in mild-to-moderate pemphigus patients | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Systematic Review | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a Pemphigus | |
| 650 | 4 | |a autoimmune bullous skin disorder | |
| 650 | 4 | |a low-dose | |
| 650 | 4 | |a rituximab | |
| 650 | 4 | |a systematic review | |
| 650 | 4 | |a ultra-low-dose | |
| 650 | 4 | |a under-standard dose | |
| 650 | 7 | |a Immunologic Factors |2 NLM | |
| 650 | 7 | |a Rituximab |2 NLM | |
| 650 | 7 | |a 4F4X42SYQ6 |2 NLM | |
| 700 | 1 | |a Aryanian, Zeinab |e verfasserin |4 aut | |
| 700 | 1 | |a Seirafianpour, Farnoosh |e verfasserin |4 aut | |
| 700 | 1 | |a Dodangeh, Milad |e verfasserin |4 aut | |
| 700 | 1 | |a Etesami, Ifa |e verfasserin |4 aut | |
| 700 | 1 | |a Daneshpazhooh, Maryam |e verfasserin |4 aut | |
| 700 | 1 | |a Balighi, Kamran |e verfasserin |4 aut | |
| 700 | 1 | |a Mahmoudi, Hamidreza |e verfasserin |4 aut | |
| 700 | 1 | |a Goodarzi, Azadeh |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Immunopharmacology and immunotoxicology |d 1996 |g 43(2021), 5 vom: 01. Okt., Seite 507-518 |w (DE-627)NLM012646636 |x 1532-2513 |7 nnns |
| 773 | 1 | 8 | |g volume:43 |g year:2021 |g number:5 |g day:01 |g month:10 |g pages:507-518 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1080/08923973.2021.1953063 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 43 |j 2021 |e 5 |b 01 |c 10 |h 507-518 | ||