Corbaux Caroline, Joly Pascal
Curr Probl Dermatol. 2018;53:64-69. doi: 10.1159/000478078. Epub 2017 Nov 7.
Autoimmune bullous diseases are a heterogeneous group of blistering diseases affecting the skin and/or mucous membrane. Systemic corticosteroids, which are often associated with immunosuppressants, are the main treatment option for these diseases. The 2 main biologics used in the treatment of autoimmune bullous diseases are rituximab, especially in pemphigus and mucous membrane pemphigoid, and omalizumab in bullous pemphigoid. Rituximab is a promising therapeutic option in pemphigus and mucous membrane pemphigoid. Its tolerance is rather good, although rare but potentially severe side effects can occur. Omalizumab has not been robustly evaluated in the treatment of bullous pemphigoid. Some case reports suggest that this drug might be of interest in a few patients with recalcitrant BP and high immunoglobulin E serum levels. Interestingly, this drug is generally well tolerated.
自身免疫性大疱性疾病是一组异质性的水疱性疾病,可累及皮肤和/或黏膜。通常与免疫抑制剂联合使用的全身性皮质类固醇是这些疾病的主要治疗选择。用于治疗自身免疫性大疱性疾病的两种主要生物制剂是利妥昔单抗,尤其用于天疱疮和黏膜类天疱疮,以及用于大疱性类天疱疮的奥马珠单抗。利妥昔单抗在天疱疮和黏膜类天疱疮中是一种有前景的治疗选择。其耐受性相当好,尽管可能会出现罕见但潜在严重的副作用。奥马珠单抗在大疱性类天疱疮治疗中的评估并不充分。一些病例报告表明,这种药物可能对少数难治性大疱性类天疱疮且血清免疫球蛋白E水平高的患者有意义。有趣的是,这种药物通常耐受性良好。