Rituximab para penfigo en Niños

Rituximab Therapy in Pediatric Pemphigus Patients

Pediatric Dermatology

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• In this study, 5 Turkish pediatric patients with juvenile pemphigus vulgaris who had failed at least two other systemic treatments or had significant adverse effects from the immunosuppressants were treated with rituximab infusions, either a fixed-dose regimen or a regimen based on body surface area. Within an average follow-up of 42.6 months, 3 patients showed complete remission and 2 partial remission.

• Rituximab can be effective and safe for the treatment of recalcitrant juvenile pemphigus vulgaris, although there is not currently a standardized protocol for its use in pediatric patients. In this retrospective case series, no infections or adverse effects on growth or development were identified.

– Margaret Hammond, MD

Written by

 

 

Robert T Brodell MD, FAAD

Rituximab has revolutionized the treatment of pemphigus in adults. There is enough evidence from case series like this one that we should not withhold this treatment from children just because definitive studies leading to FDA approval are not yet available.

Abstract

BACKGROUND/OBJECTIVES

There is inadequate knowledge regarding rituximab (RTX) administration in autoimmune bullous diseases (AIBDs), disease prevalence, clinical characteristics, and treatment outcomes within pediatric populations due to the rarity of AIBDs affecting the pediatric age group. The aim of this retrospective analysis was to evaluate the effectiveness, safety of RTX, and treatment outcomes in Turkish pediatric patients with pemphigus vulgaris (PV) and to review the literature.

METHODS

Five patients under 18 years of age and diagnosed with PV received RTX treatment and were identified in four dermatology departments of Turkey.

RESULTS

The mean age of the patients at the time of RTX therapy initiation was 15 years (range: 11-17 years), and the total duration of follow-up after RTX therapy was 42.6 months (range: 19-60 months). All patients showed a clinical response. At the last visit, complete remission off therapy was achieved in three patients. The remaining two patients achieved partial remission off therapy. No adverse events were observed.

CONCLUSIONS

This retrospective case series of five pediatric patients showed that RTX treatment can be effective and safe for the treatment of recalcitrant PV in pediatric patients. With increasing evidence, RTX is a good treatment choice in adults and pediatric patients with pemphigus.

Pediatric Dermatology

Rituximab Therapy in Pediatric Pemphigus Patients: A Retrospective Analysis of Five Turkish Patients and Review of the Literature

Pediatr Dermatol 2019 Jul 29;[EPub Ahead of Print], A Bilgic-Temel, Z Özgen, M Harman, Y Kapıcıoğlu, S Uzun 

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Benjamin Hidalgo-Matlock
Skin Care Physicians of Costa Rica

Clinica Victoria en San Pedro: 4000-1054
Momentum Escazu: 2101-9574

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