Choudhary Rajat, Gupta Vishal, Khandpur Sujay
Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India.
Indian Dermatol Online J. 2024 Aug 30;15(5):758-769. doi: 10.4103/idoj.idoj_740_23. eCollection 2024 Sep-Oct.
Autoimmune bullous diseases are associated with high morbidity and mortality. Traditionally, systemic corticosteroids and conventional immunosuppressive agents have been the mainstay of treatment, but their broad immunosuppressive effects and long-term complications have prompted the exploration of newer more targeted therapies.
This review explores the evolving landscape of therapeutic options for immunobullous diseases, with a particular focus on pemphigus, bullous pemphigoid (BP), and mucous membrane pemphigoid, by searching PubMed, clinicaltrials.gov, and Cochrane databases for published literature from 2014 to 2023.
RESULTS/DISCUSSION: We discuss emerging treatments for pemphigus such as B cell modulatory drugs, anti-inflammatory drugs, those inhibiting autoantibody half-life or blister-inducing activity, and stem cell therapy, while offering insights into the level of evidence, potential benefits, and limitations of each approach. The role of biologics and novel therapies like rituximab, omalizumab, and dupilumab in reshaping the management of BP is also discussed.
The article highlights the need for further research, clinical trials, and comparative studies to determine the most effective and safest treatment options for patients with immunobullous diseases.
自身免疫性大疱性疾病与高发病率和死亡率相关。传统上，全身用皮质类固醇和传统免疫抑制剂一直是主要的治疗方法，但它们广泛的免疫抑制作用和长期并发症促使人们探索更新的、更具针对性的疗法。
本综述通过检索PubMed、clinicaltrials.gov和Cochrane数据库，以查找2014年至2023年发表的文献，探讨免疫性大疱性疾病治疗选择的演变情况，特别关注天疱疮、大疱性类天疱疮（BP）和黏膜类天疱疮。
结果/讨论：我们讨论了天疱疮的新兴治疗方法，如B细胞调节药物、抗炎药物、抑制自身抗体半衰期或水疱诱导活性的药物以及干细胞疗法，同时深入探讨了每种方法的证据水平、潜在益处和局限性。还讨论了生物制剂以及利妥昔单抗、奥马珠单抗和度普利尤单抗等新型疗法在重塑BP治疗管理方面的作用。
本文强调需要进一步开展研究、临床试验和比较研究，以确定免疫性大疱性疾病患者最有效和最安全的治疗选择。
