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Tavakolpour S, Aryanian Z, Seirafianpour F, Dodangeh M, Etesami I, Daneshpazhooh M, Balighi K, Mahmoudi H, Goodarzi A. A systematic review on efficacy, safety, and treatment-durability of low-dose rituximab for the treatment of Pemphigus: special focus on COVID-19 pandemic concerns. Immunopharmacol Immunotoxicol 2021; 43:507-518. [PMID: 34287098 DOI: 10.1080/08923973.2021.1953063] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Rituximab is a FDA-approved monoclonal antibody for adults with moderate to severe potentially life-threatening pemphigus vulgaris. Recent studies have focused on assessments of efficacy and safety of low-dose rituximab (<2 gram in each cycle). METHOD Databases were searched from 2010 to 2020 (last update: 1 June 2020). RESULT Nine studies were entered; including180 cases (92: women, 88: men, age range: 9-83 years). The dosages of each Rituximab cycle varied between ultra-low-dose (≤500 mg for a cycle, either multiple infusions or a single infusion), low-dose (2 × 375 mg/m2 or 2 × 500 mg) and modified-dose (3 × 375 mg/m2 or 3 × 500 mg). The efficacy and safety of Rituximab in the studies are known by the recovery time, relapse time, and side events. According to the studies, 2 × 500 can lead to complete remission in a broad range, from 35 to 82%. These differences might be explained by different end-points and variable cumulative corticosteroid dosage after RTX administration. Although the studies showed that low dose RTX is efficient, there are some controversies regarding the choosing low-dose for severe patients. CONCLUSION Considering the effectiveness of low-dose, intermediate dose, and ultra-low-dose protocols of Rituximab in inducing remission in pemphigus disease and considering factors such as cost of therapy, and the need to induce a minimum of immunosuppression for a minimum duration in the COVID-19 pandemic, suggested to use low-dose Rituximab protocol (2 infusions of 500 mg Rituximab: interval of 2 weeks) to induce the remission in mild-to-moderate pemphigus patients.
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Affiliation(s)
| | - Zeinab Aryanian
- Autoimmune Bullous Diseases Research Center, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran.,Department of Dermatology, Babol University of Medical Sciences, Babol, Iran
| | - Farnoosh Seirafianpour
- Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Milad Dodangeh
- Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ifa Etesami
- Autoimmune Bullous Diseases Research Center, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Daneshpazhooh
- Autoimmune Bullous Diseases Research Center, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Kamran Balighi
- Autoimmune Bullous Diseases Research Center, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamidreza Mahmoudi
- Autoimmune Bullous Diseases Research Center, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Azadeh Goodarzi
- Department of Dermatology, Rasool Akram Medical Complex, Iran University of Medical Sciences, Tehran, Iran
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Fahmy DH, El-Amawy HS, El-Samongy MA, Fouda AA, Soliman SH, El-Kady A, Farnetani F, Conti A, Zoeir A, Eissa A, Eissa R, Puliatti S, Sighinolfi MC, Rocco B, Pellacani G. COVID-19 and dermatology: a comprehensive guide for dermatologists. J Eur Acad Dermatol Venereol 2020; 34:1388-1394. [PMID: 32428303 PMCID: PMC7276795 DOI: 10.1111/jdv.16545] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Linked articles: COVID‐19 SPECIAL FORUM. J Eur Acad Dermatol Venereol 2020; 34: e291–e310.
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Affiliation(s)
- D H Fahmy
- Dermatology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - H S El-Amawy
- Dermatology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - M A El-Samongy
- Dermatology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - A A Fouda
- Dermatology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - S H Soliman
- Dermatology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - A El-Kady
- Dermatology Department, El-Menshawy Hospital, Ministry of Health & Population, Tanta, Egypt
| | - F Farnetani
- Dermatology Department, University of Modena & Reggio Emilia, Modena, Italy
| | - A Conti
- Dermatology Department, Azienda Ospedaliero Universitaria of Modena, Modena, Italy
| | - A Zoeir
- Urology Department, University of Modena & Reggio Emilia, Modena, Italy.,Urology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - A Eissa
- Urology Department, University of Modena & Reggio Emilia, Modena, Italy.,Urology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - R Eissa
- Microbiology & Virology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - S Puliatti
- Urology Department, University of Modena & Reggio Emilia, Modena, Italy.,ORSI Academy, Melle, Belgium
| | - M C Sighinolfi
- Urology Department, University of Modena & Reggio Emilia, Modena, Italy
| | - B Rocco
- Urology Department, University of Modena & Reggio Emilia, Modena, Italy
| | - G Pellacani
- Dermatology Department, University of Modena & Reggio Emilia, Modena, Italy
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Marasca C, Ruggiero A, Megna M, Annunziata MC, Fabbrocini G. Biologics for patients affected by hidradenitis suppurativa in the COVID-19 era: data from a referral center of Southern Italy. J DERMATOL TREAT 2020; 33:592. [PMID: 32403954 DOI: 10.1080/09546634.2020.1769828] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Claudio Marasca
- Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples Federico II, Naples, Italy
| | - Angelo Ruggiero
- Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples Federico II, Naples, Italy
| | - Matteo Megna
- Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples Federico II, Naples, Italy
| | - Maria Carmela Annunziata
- Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples Federico II, Naples, Italy
| | - Gabriella Fabbrocini
- Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples Federico II, Naples, Italy
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Conforti C, Giuffrida R, Dianzani C, Di Meo N, Zalaudek I. Biologic therapy for psoriasis during the COVID-19 outbreak: The choice is to weigh risks and benefits. Dermatol Ther 2020; 33:e13490. [PMID: 32358864 PMCID: PMC7261974 DOI: 10.1111/dth.13490] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 04/20/2020] [Accepted: 04/27/2020] [Indexed: 01/04/2023]
Affiliation(s)
- Claudio Conforti
- Department of Dermatology and Venereology, Dermatology Clinic, Maggiore Hospital, University of Trieste, Trieste, Italy
| | - Roberta Giuffrida
- Department of Clinical and Experimental Medicine, Section of Dermatology, University of Messina, Messina, Italy
| | - Caterina Dianzani
- Department of Plastic, Reconstructive and Cosmetic Surgery, Dermatology Section, Campus Bio-Medico University Hospital, Rome, Italy
| | - Nicola Di Meo
- Department of Dermatology and Venereology, Dermatology Clinic, Maggiore Hospital, University of Trieste, Trieste, Italy
| | - Iris Zalaudek
- Department of Dermatology and Venereology, Dermatology Clinic, Maggiore Hospital, University of Trieste, Trieste, Italy
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Megna M, Ruggiero A, Marasca C, Fabbrocini G. Biologics for psoriasis patients in the COVID-19 era: more evidence, less fears. J DERMATOL TREAT 2020; 31:328-329. [DOI: 10.1080/09546634.2020.1757605] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Matteo Megna
- Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples Federico II, Napoli, Italy
| | - Angelo Ruggiero
- Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples Federico II, Napoli, Italy
| | - Claudio Marasca
- Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples Federico II, Napoli, Italy
| | - Gabriella Fabbrocini
- Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples Federico II, Napoli, Italy
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