{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T11:59:27Z","timestamp":1788609567166,"version":"build-2803163510"},"reference-count":24,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2022,7,15]],"date-time":"2022-07-15T00:00:00Z","timestamp":1657843200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Rituximab (RTX) is a monoclonal antibody directed against CD20 antigen indicated in an increasing number of immune-mediated diseases. While its efficacy in pemphigus vulgaris has been widely investigated, only a few data about its possible role in pemphigoid diseases have been reported in the literature. Accordingly, herein we evaluated a case series of patients with mucous membrane pemphigoid (MMP) treated with RTX. We included patients with a history of severe\/refractory MMP who received at least one cycle of intravenous RTX between May 2018 and December 2021 and had 6 months of follow-up time. Disease control (DC) was our early endpoint, while complete remission (CR) and partial remission (PR) were late endpoints. CR off-therapy, relapses, and adverse events were evaluated as well. Our population included 10 MMP patients. Eight out of ten patients (80%) achieved DC in a mean of 8 weeks, while two patients with ocular MMP were non-responders. Among the eight patients who achieved DC, two reached CR off therapy, two CR on minimal therapy, and two achieved PR on minimal therapy. In our case series, the addition of RTX to conventional therapies was demonstrated to be safe and effective in reaching rapid disease control in the majority of refractory MMP patients.<\/jats:p>","DOI":"10.3390\/jcm11144102","type":"journal-article","created":{"date-parts":[[2022,7,17]],"date-time":"2022-07-17T22:57:06Z","timestamp":1658098626000},"page":"4102","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Rituximab in Mucous Membrane Pemphigoid: A Monocentric Retrospective Study in 10 Patients with Severe\/Refractory Disease"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8454-7617","authenticated-orcid":false,"given":"Maria Efenesia","family":"Baffa","sequence":"first","affiliation":[{"name":"Department of Health Sciences, Section of Dermatology, University of Florence, 50125 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0903-4998","authenticated-orcid":false,"given":"Alberto","family":"Corr\u00e0","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Section of Dermatology, University of Florence, 50125 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Maglie","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Section of Dermatology, University of Florence, 50125 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena Biancamaria","family":"Mariotti","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Section of Dermatology, University of Florence, 50125 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Montefusco","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Section of Dermatology, University of Florence, 50125 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Pipit\u00f2","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Section of Dermatology, University of Florence, 50125 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Senatore","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Section of Dermatology, University of Florence, 50125 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lavinia","family":"Quintarelli","sequence":"additional","affiliation":[{"name":"Rare Skin Diseases Unit, Azienda USL Toscana Centro, Department of Health Sciences, University of Florence, 50125 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marzia","family":"Caproni","sequence":"additional","affiliation":[{"name":"Rare Skin Diseases Unit, Azienda USL Toscana Centro, Department of Health Sciences, University of Florence, 50125 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7787-4433","authenticated-orcid":false,"given":"Emiliano","family":"Antiga","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Section of Dermatology, University of Florence, 50125 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,7,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1016\/S0140-6736(12)61140-4","article-title":"Pemphigoid diseases","volume":"26","author":"Schmidt","year":"2013","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1001\/archderm.138.3.370","article-title":"The first international consensus on mucous membrane pemphigoid: Definition, diagnostic criteria, pathogenic factors, medical treatment, and prognostic indicators","volume":"138","author":"Chan","year":"2002","journal-title":"Arch. Dermatol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"363","DOI":"10.3109\/08923973.2011.608684","article-title":"Mucous membrane pemphigoid affecting the oral cavity: Short review on etiopathogenesis, diagnosis and treatment","volume":"34","author":"Petruzzi","year":"2012","journal-title":"Immunopharmacol. Immunotoxicol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1926","DOI":"10.1111\/jdv.17395","article-title":"European Guidelines (S3) on diagnosis and management of mucous membrane pemphigoid, initiated by the European Academy of Dermatology and Venereology\u2014Part II","volume":"35","author":"Schmidt","year":"2021","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1750","DOI":"10.1111\/jdv.17397","article-title":"European guidelines (S3) on diagnosis and management of mucous membrane pemphigoid, initiated by the European Academy of Dermatology and Venereology\u2014Part I","volume":"35","author":"Rashid","year":"2021","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.intimp.2008.10.004","article-title":"A review of the current use of rituximab in autoimmune diseases","volume":"9","author":"Gurcan","year":"2009","journal-title":"Int. Immunopharmacol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1016\/j.jaad.2014.08.024","article-title":"Definitions and outcome measures for mucous membrane pemphigoid: Recommendations of an international panel of experts","volume":"72","author":"Murrell","year":"2015","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1221","DOI":"10.1007\/s00417-017-3603-3","article-title":"Rituximab in the treatment of ocular cicatricial pemphigoid: A retrospective cohort study","volume":"255","author":"You","year":"2017","journal-title":"Graefe\u2019s Arch. Clin. Exp. Ophthalmol."},{"key":"ref_9","unstructured":"European Medicines Agency (2021, November 26). MabThera\u00ae (Rituximab) Summary of Product Characteristics [updated 10\/09\/2021]. Available online: https:\/\/www.ema.europa.eu\/en\/medicines\/human\/EPAR\/mabthera."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1418","DOI":"10.3389\/fimmu.2019.01418","article-title":"Pemphigus: Current and Future Therapeutic Strategies","volume":"25","author":"Didona","year":"2019","journal-title":"Front. Immunol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1016\/j.clindermatol.2019.07.023","article-title":"Rituximab in autoimmune pemphigoid diseases: Indications, optimized regimens, and practice Gaps","volume":"38","author":"Thomas","year":"2020","journal-title":"Clin. Dermatol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1007\/s11926-017-0632-1","article-title":"Rituximab in ANCA-associated vasculitis","volume":"19","author":"Hassan","year":"2017","journal-title":"Curr. Rheumatol. Rep."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2031","DOI":"10.1016\/S0140-6736(17)30070-3","article-title":"French study group on autoimmune bullous skin diseases. First-line rituximab combined with short-term prednisone versus prednisone alone for the treatment of pemphigus (Ritux 3): A prospective, multicentre, parallel-group, open-label randomised trial","volume":"389","author":"Joly","year":"2017","journal-title":"Lancet"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"248","DOI":"10.3389\/fimmu.2018.00248","article-title":"Effectiveness and Safety of Rituximab in Recalcitrant Pemphigoid Diseases","volume":"9","author":"Lamberts","year":"2018","journal-title":"Front. Immunol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1111\/j.1365-2133.2011.10411.x","article-title":"Clinical efficacy of different doses of rituximab in the treatment of pemphigus: A retrospective study of 27 patients","volume":"165","author":"Kim","year":"2011","journal-title":"Br. J. Dermatol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"928","DOI":"10.2340\/00015555-2116","article-title":"Efficacy of rituximab for pemphigus: A systematic review and meta-analysis of different regimens","volume":"95","author":"Wang","year":"2015","journal-title":"Acta. Derm. Venereol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1146\/annurev-pathol-012615-044313","article-title":"Mechanisms of disease: Pemphigus and bullous pemphigoid","volume":"11","author":"Hammers","year":"2016","journal-title":"Annu. Rev. Pathol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1527","DOI":"10.1007\/s40265-018-0976-5","article-title":"Targeted Therapies for Autoimmune Bullous Diseases: Current Status","volume":"78","author":"Amber","year":"2018","journal-title":"Drugs"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1001\/archdermatol.2011.54","article-title":"Rituximab for patients with refractory mucous membrane pemphigoid","volume":"147","author":"Alexandre","year":"2011","journal-title":"Arch. Dermatol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1237","DOI":"10.1016\/j.jaad.2019.11.023","article-title":"Clinical outcome and safety of rituximab therapy for pemphigoid diseases","volume":"82","author":"Tovanabutra","year":"2020","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_21","first-page":"S0190-962200010-4","article-title":"Biologic treatment outcomes in mucous membrane pemphigoid: A systematic review","volume":"7","author":"Lytvyn","year":"2021","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1016\/j.jaad.2013.01.046","article-title":"Treatment of mucous membrane pemphigoid with rituximab","volume":"69","author":"Heelan","year":"2013","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_23","first-page":"1","article-title":"The efficacy of rituximab in patients with mucous membrane pemphigoid","volume":"11","author":"Moslemkhani","year":"2020","journal-title":"J. Dermatolog. Treat"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1016\/j.jaad.2012.10.018","article-title":"Critical analysis of the use of rituximab in mucous membrane pemphigoid: A review of the literature","volume":"68","author":"Shetty","year":"2013","journal-title":"J. Am. Acad. Dermatol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/14\/4102\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:51:06Z","timestamp":1760140266000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/14\/4102"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,15]]},"references-count":24,"journal-issue":{"issue":"14","published-online":{"date-parts":[[2022,7]]}},"alternative-id":["jcm11144102"],"URL":"https:\/\/doi.org\/10.3390\/jcm11144102","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7,15]]}}}