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Serge Doan, Sophie Stephan, Catherine Prost, Marina Alexandre, Isabelle Cochereau, Eric Gabison; Efficacy of rituximab in severe ocular cicatricial pemphigoid. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2115.
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To report the efficacy of rituximab in patients with severe ocular cicatricial pemphigoid (OCP).
In this non controlled retrospective study, 18 patients with severe OCP (8 males, 10 females ; median age, 73 years ; 31 eyes) were treated with rituximab, because of toxicity or resistance to cyclophosphamide (in 10 and 4 cases, respectively), or of rapid evolutivity (4 cases). The treatment consisted of 4 weekly intravenous administrations (375 mg/m2) or 2 monthly intravenous administrations (1 gram). This treatment was repeated in case of persistent conjunctival inflammation. Complete remission was defined as the absence of conjunctival inflammation.
Complete remission was obtained in 16 patients (89%) within a median period of 2.5 months (range, 1 to 6 months) after 1 or 2 treatments (in 12 and 4 patients, respectively). The disease recurred in 5 of the 16 patients after 6 to 27 months. Complete remission was obtained after an additional rituximab treatment. Median follow up without any recurrence was 21 months (range, 12 to 54 months). No serious adverse effect was noted.
Rituximab is a potent treatment of severe OCP. It is particularly interesting in case of resistance or contraindication to cyclophosphamide, or in rapidly evolutive forms.
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