title: Future therapies for pemphigus vulgaris: Rituximab and beyond.
abstract: The conventional treatment for patients with pemphigus vulgaris (PV) centers on global immunosuppression, such as the use of steroids and other immunosuppressive drugs, to decrease titers of antidesmoglein autoantibodies responsible for the acantholytic blisters. Global immunosuppressants, however, cause serious side effects. The emergence of anti-CD20 biologic medications, such as rituximab, as an adjunct to conventional therapy has shifted the focus to targeted destruction of autoimmune B cells. Next-generation biologic medications with improved modes of delivery, pharmacology, and side effect profiles are constantly being developed, adding to the diversity of options for PV treatment. We review promising monoclonal antibodies, including veltuzumab, obinutuzumab (GA-101), ofatumumab, ocaratuzumab (AME-133v), PRO131921, and belimumab.
authors.affiliation: Department of Dermatology, State University of New York Downstate Medical Center, New York, New York.
authors.forename: Amy
authors.initials: A
authors.lastname: Huang
authors.affiliation: Department of Dermatology, State University of New York Downstate Medical Center, New York, New York. Electronic address: raman.madan@downstate.edu.
authors.forename: Raman K
authors.initials: RK
authors.lastname: Madan
authors.affiliation: Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Jacob
authors.initials: J
authors.lastname: Levitt
mesh_terms: D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects / Q000627:therapeutic use*; D001688:Biological Products / Q000009:adverse effects / Q000627:therapeutic use*; D015331:Cohort Studies; D005260:Female; D005544:Forecasting; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D010392:Pemphigus / Q000175:diagnosis* / Q000188:drug therapy*; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D000069283:Rituximab / Q000009:adverse effects / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D001688:Biological Products; D007166:Immunosuppressive Agents; D000069283:Rituximab; C511911:belimumab; C493846:veltuzumab; C527517:ofatumumab; C543332:obinutuzumab
keywords: anti-CD20; autoimmune; biologics; blistering diseases; desmoglein; desmosomes; immunomodulators; immunosuppression; monoclonal antibodies; pemphigus vulgaris; rituximab