What is novel in the clinical management of pemphigus

Expert Rev Clin Pharmacol. 2019 Oct;12(10):973-980. doi: 10.1080/17512433.2019.1670059. Epub 2019 Sep 29.

Abstract

Introduction: Pemphigus, an autoimmune disease group characterized by blisters and erosions of the skin and/or mucosal membranes has been treated with systemic corticosteroids (CS) and immunosuppressive therapies for the past few decades. Areas Covered: However, common adverse effects and complications of long-term CS and immunosuppressive drugs are limiting their long-term use. The disease results in death if not treated. Thus, currently, researchers are trying to develop new and safer therapeutic approaches. Specifically, targeted therapies to pathogenic immune pathways are under investigation. The B cell inhibitors which block CD20 and CD19 are the main new drugs investigated in clinical trials as alternatives to systemic steroids. Expert Opinion: Randomized controlled trial (RCT) Level evidence shows that rituximab and short course CSs are more effective and safer than standard CS treatment. Specific BTK inhibitors have shown promise in data from a phase II international open-label study. Further studies are ongoing.

Keywords: BTK inhibitors; Pemphigus; management; ofatumumab; rituximab; targeted therapies; treatment.

Publication types

  • Comparative Study
  • Review

MeSH terms

  • Adrenal Cortex Hormones / administration & dosage*
  • Adrenal Cortex Hormones / adverse effects
  • Adrenal Cortex Hormones / pharmacology
  • Agammaglobulinaemia Tyrosine Kinase / antagonists & inhibitors
  • Animals
  • Drug Development / methods
  • Humans
  • Immunosuppressive Agents / administration & dosage*
  • Immunosuppressive Agents / adverse effects
  • Immunosuppressive Agents / pharmacology
  • Molecular Targeted Therapy
  • Pemphigus / drug therapy*
  • Pemphigus / immunology
  • Pemphigus / pathology
  • Randomized Controlled Trials as Topic
  • Rituximab / administration & dosage
  • Rituximab / adverse effects
  • Time Factors

Substances

  • Adrenal Cortex Hormones
  • Immunosuppressive Agents
  • Rituximab
  • Agammaglobulinaemia Tyrosine Kinase
  • BTK protein, human