Low-Dose IL-2 Therapy Improves Disease Control in Bullous Pemphigoid Patients, suggests research

A recent study published in the Journal of the American Academy of Dermatology demonstrated that low-dose IL-2 therapy may be an effective treatment for patients with moderate to severe bullous pemphigoid (BP), a chronic autoimmune blistering disorder. The research assessed the response to IL-2 therapy, suggests that it could significantly shorten the time required to achieve disease control when combined with standard corticosteroid treatment.

Bullous pemphigoid is characterized by the formation of large, fluid-filled blisters primarily affecting the elderly. Current treatments primarily rely on systemic corticosteroids, which can lead to serious side effects, especially when used long-term. The reduction of Regulatory T cells (Tregs) in both the peripheral blood and skin lesions of BP patients has been identified as a critical factor in the disease's pathogenesis. Given that low-dose IL-2 therapy can selectively stimulate Tregs, this study wanted to find if it could offer a novel therapeutic approach for BP.

The study included a total of 43 patients with moderate to severe BP who were divided into 2 groups. Both groups received systemic corticosteroids, with the dosage tailored to disease severity of 0.5 mg/kg/day for moderate cases and 1.0 mg/kg/day for severe cases. The control group received only corticosteroids and allowed immunosuppressants, while the treatment group received an additional low-dose IL-2 therapy (half a million IU administered subcutaneously every other day for eight weeks).

The primary outcome measured was the time required to achieve disease control. The treatment group, which received IL-2, reached disease control in an average of 7.60 days, significantly faster than the control group, which took an average of 10.43 days (p=0.008). This reduction in time is clinically significant, suggesting that low-dose IL-2 therapy not only hastens the healing process but also potentially reduces the overall burden of corticosteroid use.

Also, the study found that the total amount of corticosteroids required by the treatment group was markedly lower when compared to the control group. No serious infections were reported in the IL-2 group which addresses the concerns about the safety of this approach. The findings of the study offer strong evidence that low-dose IL-2 therapy could improve current BP treatment protocols by reducing the need for high-dose corticosteroids and achieving faster disease control. Overall, this study illuminates the potential of IL-2 therapy as a promising adjunct in the management of bullous pemphigoid. 

Reference:

Xue, R., Li, G., Zhou, Y., Wang, B., Xu, Y., Zhao, P., Teng, L., Zheng, J., Liu, H., Ji, S., Elston, D. M., & Liang, Y. (2024). Efficacy and safety of low-dose Interleukin-2 in the treatment of moderate to severe bullous pemphigoid: a single center perspective-controlled trial. In Journal of the American Academy of Dermatology. Elsevier BV. https://doi.org/10.1016/j.jaad.2024.08.033