title: Rituximab combined with conventional therapy versus conventional therapy alone for the treatment of mucous membrane pemphigoid (MMP).
abstract: BACKGROUND
  The use of rituximab for refractory autoimmune blistering diseases is increasing. Data related to rituximab for the treatment of mucous membrane pemphigoid (MMP) are limited.
  
  
  OBJECTIVE
  We sought to compare the efficacy of adding rituximab with traditional immunosuppressive therapies in the treatment of MMP. The primary outcome was achievement and time to disease control.
  
  
  METHODS
  Patients with a diagnosis of MMP from August 2001 to June 2015 who had greater than 6 months of follow-up after the initiation of therapy were reviewed.
  
  
  RESULTS
  In all, 24 patients were treated with rituximab and 25 were treated with conventional immunosuppression. Of patients, 100% in the rituximab group achieved disease control compared with 40% in the conventional group (P < .01), with a mean time to disease control of 10.17 months and 37.7 months (P = .02). Adverse events were seen in 33% of patients after rituximab, compared with 48% of patients in the conventional group (P = .2).
  
  
  CONCLUSIONS
  Rituximab dosing was not uniform and the 2 groups were not matched in terms of disease severity, nor were they randomized.
  
  
  CONCLUSIONS
  Our study indicates that the addition of rituximab to conventional therapy in patients with MMP results in more rapid and sustained disease control with potentially fewer adverse events.
authors.affiliation: Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia.
authors.forename: Alexander
authors.initials: A
authors.lastname: Maley
authors.affiliation: Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia.
authors.forename: Maxine
authors.initials: M
authors.lastname: Warren
authors.affiliation: Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia.
authors.forename: Ilyse
authors.initials: I
authors.lastname: Haberman
authors.affiliation: Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia.
authors.forename: Robert
authors.initials: R
authors.lastname: Swerlick
authors.affiliation: Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia.
authors.forename: Bhairavi
authors.initials: B
authors.lastname: Kharod-Dholakia
authors.affiliation: Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia. Electronic address: ron.j.feldman@emory.edu.
authors.forename: Ron
authors.initials: R
authors.lastname: Feldman
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D005845:Georgia; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010390:Pemphigoid, Benign Mucous Membrane / Q000175:diagnosis* / Q000188:drug therapy* / Q000276:immunology; D012189:Retrospective Studies; D018570:Risk Assessment; D000069283:Rituximab / Q000009:adverse effects / Q000627:therapeutic use*; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D000069283:Rituximab
keywords: autoimmune blistering disease; cicatricial pemphigoid; immunosuppression; mucous membrane pemphigoid; ocular pemphigoid; rituximab