title: Rituximab preserves vision in ocular mucous membrane pemphigoid.
abstract: OBJECTIVE
  To study the effectiveness and safety of anti-CD20 B-cell antibody rituximab (RTX) in the treatment of ocular mucous membrane pemphigoid (MMP).
  
  
  METHODS
  Retrospective analysis of six MMP patients receiving RTX with or without concomitant immunosuppression. RTX was administered as a high dose regimen (1000 mg/infusion, day 0 and day 14/cycle). Five patients received more than one cycle. Main outcome measure was the treatment response, defined as complete remission (CR) or partial remission (PR), monitored at 16 and 24 weeks. As secondary outcome measure, drug-related adverse events were evaluated.
  
  
  RESULTS
  All patients responded within 16 weeks. Initial treatment response vanished in five of six patients at a mean of 10 months (± 4.4 standard deviation [SD]). A second cycle was initiated thereafter (interval 12 months ± 6.4 SD) resulting in CR in two of five and PR in three of five patients. One patient stabilized only when additional immunosuppression was initiated. Mean follow up was 22 months (± 8.2 SD).Two individuals experienced infusion reactions.
  
  
  CONCLUSIONS
  Our study adds long-term data to the very limited experience with biologicals in MMP, indicating that RTX is a promising option for patients with advanced disease. We report for the first time the high dose regimen of RTX applied in a consecutive series.
authors.affiliation: Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum , Ophthalmology , Augustenburger Platz 1, Berlin, 13353 , Germany anne.ruebsam@charite.de.
authors.forename: Anne
authors.initials: A
authors.lastname: Rübsam
authors.forename: Richard
authors.initials: R
authors.lastname: Stefaniak
authors.forename: Margitta
authors.initials: M
authors.lastname: Worm
authors.forename: Uwe
authors.initials: U
authors.lastname: Pleyer
mesh_terms: D000293:Adolescent; D000368:Aged; D000369:Aged, 80 and over; D018951:Antigens, CD20 / Q000378:metabolism; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001402:B-Lymphocytes / Q000166:cytology / Q000276:immunology / Q000378:metabolism; D004333:Drug Administration Routes; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007165:Immunosuppression Therapy; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010390:Pemphigoid, Benign Mucous Membrane / Q000188:drug therapy* / Q000473:pathology; D012074:Remission Induction; D012189:Retrospective Studies; D000069283:Rituximab / Q000627:therapeutic use*; D016896:Treatment Outcome; D014792:Visual Acuity
chemical_list: D018951:Antigens, CD20; D000970:Antineoplastic Agents; D007166:Immunosuppressive Agents; D000069283:Rituximab
keywords: ocular mucous membrane pemphigoid; rituximab; symblephara; therapy