College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Department of Dermatology, University of Arkansas for Medical Sciences, 4301 W. Markham St., Slot #576, Little Rock, AR, 72205, USA.
Am J Clin Dermatol. 2023 Mar;24(2):247-273. doi: 10.1007/s40257-022-00751-7. Epub 2023 Jan 11.
Biologic therapies targeting B-cells are emerging as an effective strategy to treat a variety of immune-mediated diseases. One of the most studied B-cell-targeted therapies is rituximab, an anti-CD20 monoclonal antibody that exemplifies B-cell depletion therapy and has served as the prototype for other anti-CD20 monoclonal antibodies and the development of biosimilars. While there are multiple studies on the use of rituximab in dermatology, a comprehensive review of rituximab therapy in autoimmune skin conditions is lacking. In this literature review, we summarize indications, treatment efficacy, and safety of rituximab among common autoimmune diseases of the skin: pemphigus vulgaris, cutaneous lupus erythematous, dermatomyositis, systemic sclerosis, thyroid dermopathy, autoimmune pemphigoid diseases, and cutaneous vasculitis diseases. Existing data on rituximab support the approach of rituximab, biosimilars, and newer B-cell-targeting therapies in immune-mediated cutaneous diseases. Overall, rituximab, which targets CD20, provides an effective alternative or concomitant option to traditional immunosuppressants in the management of various autoimmune diseases of the skin. Further studies are necessary to expand the understanding and possible utility of B-cell-targeted therapies among autoimmune skin diseases.
针对 B 细胞的生物疗法正成为治疗多种免疫介导性疾病的有效策略。研究最多的 B 细胞靶向治疗之一是利妥昔单抗,一种抗 CD20 单克隆抗体,它是 B 细胞耗竭疗法的典范,也是其他抗 CD20 单克隆抗体和生物类似药开发的原型。虽然有许多关于利妥昔单抗在皮肤病学中应用的研究,但缺乏对自身免疫性皮肤病中利妥昔单抗治疗的全面综述。在这篇文献综述中,我们总结了利妥昔单抗在常见自身免疫性皮肤病中的适应证、治疗效果和安全性:寻常型天疱疮、红斑狼疮、皮肌炎、系统性硬化症、甲状腺皮肤病、自身免疫性大疱性皮肤病和皮肤血管炎疾病。关于利妥昔单抗的现有数据支持在免疫介导性皮肤病中应用利妥昔单抗、生物类似药和新型 B 细胞靶向治疗。总体而言,针对 CD20 的利妥昔单抗为治疗各种自身免疫性皮肤病提供了一种有效的替代或联合传统免疫抑制剂的选择。需要进一步研究以扩大对 B 细胞靶向治疗在自身免疫性皮肤病中的理解和可能应用。