Infectological evaluation of the patient with autoimmune bullous dermatosis who will use rituximab
Keywords:
immunosuppression, pemphigus, rituximabAbstract
Conventional treatment of patients with autoimmune bullous diseases relies on global immunosuppression with the use of corticosteroids and other immunosuppressive drugs to decrease the titers of autoantibodies responsible for these diseases. In recent years the appearance of biological therapy has improved the management and prognosis of them. Rituximab (RTX) is a chimeric (murine) monoclonal antibody, targeting CD20 on both normal and malignant B lymphocytes, and leading to a rapid depletion of these cells for 6 to 9 months. In Argentina, Administración Nacional de Medicamentos, Alimentos y Tecnología Médica (ANMAT) approved rituximab in 2012, under the same indications as the Food and Drug Administration (FDA), with bullous diseases being also an indication outside the accepted (“off label”), although some authors already consider it the first line of treatment for patients with moderate to severe pemphigus. However, rituximab can cause adverse effects and complications, so it is important to take preventive measures. This paper summarizes the main considerations to be taken into account in a patient receiving biological therapy.References
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