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Development of Antirituximab Antibodies May Portend Therapy Failure in Patients with Pemphigus
Outcomes were not as good in rituximab recipients who developed antichimeric antibodies as in those who did not.
Rituximab is a chimeric antibody that appears to be useful in the management of pemphigus. However, antichimeric antibodies might develop in treated patients, and if so, the implications of this development are not understood.
These authors report outcomes in 11 pemphigus patients who were treated with rituximab therapy, in 2 of whom antirituximab antibodies developed. These two patients did not experience more than partial remission, and eventually, they had increased disease activity. Their outcomes contrast sharply with outcomes in the nine patients who did not develop these antibodies. Of those patients, five had complete response and four had partial remission without a subsequent increase in disease activity.
Comment: Antichimeric antibodies develop in some patients undergoing rituximab therapy; presence of these antibodies might predict (and perhaps explain) lower treatment efficacy.
Published in Journal Watch Dermatology September 4, 2009
Citation(s):
Schmidt E et al. Immunogenicity of rituximab in patients with severe pemphigus. Clin Immunol 2009 Sep; 132:334. (http://dx.doi.org/10.1016/j.clim.2009.05.007)
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