Medical Dialogues
  • Dermatology
Login Register
This site is intended for healthcare professionals only
Login Register
  • MD Brand Connect
  • Vaccine Hub
  • MDTV
    • Breaking News
    • Medical News Today
    • Health News Today
    • Latest
    • Journal Club
    • Medico Legal Update
    • Latest Webinars
    • MD Shorts
    • Health Dialogues
  • Fact Check
  • Health Dialogues
Medical Dialogues
  • Medical News & Guidelines
      • Anesthesiology
      • Cardiology and CTVS
      • Critical Care
      • Dentistry
      • Dermatology
      • Diabetes and Endocrinology
      • ENT
      • Gastroenterology
      • Medicine
      • Nephrology
      • Neurology
      • Obstretics-Gynaecology
      • Oncology
      • Ophthalmology
      • Orthopaedics
      • Pediatrics-Neonatology
      • Psychiatry
      • Pulmonology
      • Radiology
      • Surgery
      • Urology
      • Laboratory Medicine
      • Diet
      • Nursing
      • Paramedical
      • Physiotherapy
  • Health news
      • Doctor News
      • Government Policies
      • Hospital & Diagnostics
      • International Health News
      • Medical Organization News
      • Medico Legal News
      • NBE News
      • NMC News
  • Fact Check
      • Bone Health Fact Check
      • Brain Health Fact Check
      • Cancer Related Fact Check
      • Child Care Fact Check
      • Dental and oral health fact check
      • Diabetes and metabolic health fact check
      • Diet and Nutrition Fact Check
      • Eye and ENT Care Fact Check
      • Fitness fact check
      • Gut health fact check
      • Heart health fact check
      • Kidney health fact check
      • Medical education fact check
      • Men's health fact check
      • Respiratory fact check
      • Skin and hair care fact check
      • Vaccine and Immunization fact check
      • Women's health fact check
  • AYUSH
    • Ayurveda
    • Homeopathy
    • Siddha
    • Unani
    • Yoga
  • State News
      • Andaman and Nicobar Islands
      • Andhra Pradesh
      • Arunachal Pradesh
      • Assam
      • Bihar
      • Chandigarh
      • Chattisgarh
      • Dadra and Nagar Haveli
      • Daman and Diu
      • Delhi
      • Goa
      • Gujarat
      • Haryana
      • Himachal Pradesh
      • Jammu & Kashmir
      • Jharkhand
      • Karnataka
      • Kerala
      • Ladakh
      • Lakshadweep
      • Madhya Pradesh
      • Maharashtra
      • Manipur
      • Meghalaya
      • Mizoram
      • Nagaland
      • Odisha
      • Puducherry
      • Punjab
      • Rajasthan
      • Sikkim
      • Tamil Nadu
      • Telangana
      • Tripura
      • Uttar Pradesh
      • Uttrakhand
      • West Bengal
  • Medical Education
      • Ayush Education News
      • Dentistry Education News
      • Medical Admission News
      • Medical Colleges News
      • Medical Courses News
      • Medical Universities News
      • Nursing education News
      • Paramedical Education News
      • Study Abroad
  • Industry
      • Health Investment News
      • Health Startup News
      • Medical Devices News
      • Pharma News
      • Pharmacy Education News
      • Industry Perspective
  • MDTV
      • Health Dialogues MDTV
      • Health News today MDTV
      • Latest Videos MDTV
      • Latest Webinars MDTV
      • MD shorts MDTV
      • Medical News Today MDTV
      • Medico Legal Update MDTV
      • Top Videos MDTV
      • Health Perspectives MDTV
      • Journal Club MDTV
      • Medical Dialogues Show
This site is intended for healthcare professionals only
LoginRegister
Medical Dialogues
LoginRegister
  • Home
  • Medical news & Guidelines
    • Anesthesiology
    • Cardiology and CTVS
    • Critical Care
    • Dentistry
    • Dermatology
    • Diabetes and Endocrinology
    • ENT
    • Gastroenterology
    • Medicine
    • Nephrology
    • Neurology
    • Obstretics-Gynaecology
    • Oncology
    • Ophthalmology
    • Orthopaedics
    • Pediatrics-Neonatology
    • Psychiatry
    • Pulmonology
    • Radiology
    • Surgery
    • Urology
    • Laboratory Medicine
    • Diet
    • Nursing
    • Paramedical
    • Physiotherapy
  • Health news
    • Doctor News
    • Government Policies
    • Hospital & Diagnostics
    • International Health News
    • Medical Organization News
    • Medico Legal News
    • NBE News
    • NMC News
  • Fact Check
    • Bone Health Fact Check
    • Brain Health Fact Check
    • Cancer Related Fact Check
    • Child Care Fact Check
    • Dental and oral health fact check
    • Diabetes and metabolic health fact check
    • Diet and Nutrition Fact Check
    • Eye and ENT Care Fact Check
    • Fitness fact check
    • Gut health fact check
    • Heart health fact check
    • Kidney health fact check
    • Medical education fact check
    • Men's health fact check
    • Respiratory fact check
    • Skin and hair care fact check
    • Vaccine and Immunization fact check
    • Women's health fact check
  • AYUSH
    • Ayurveda
      • Ayurveda Giuidelines
      • Ayurveda News
    • Homeopathy
      • Homeopathy Guidelines
      • Homeopathy News
    • Siddha
      • Siddha Guidelines
      • Siddha News
    • Unani
      • Unani Guidelines
      • Unani News
    • Yoga
      • Yoga Guidelines
      • Yoga News
  • State News
    • Andaman and Nicobar Islands
    • Andhra Pradesh
    • Arunachal Pradesh
    • Assam
    • Bihar
    • Chandigarh
    • Chattisgarh
    • Dadra and Nagar Haveli
    • Daman and Diu
    • Delhi
    • Goa
    • Gujarat
    • Haryana
    • Himachal Pradesh
    • Jammu & Kashmir
    • Jharkhand
    • Karnataka
    • Kerala
    • Ladakh
    • Lakshadweep
    • Madhya Pradesh
    • Maharashtra
    • Manipur
    • Meghalaya
    • Mizoram
    • Nagaland
    • Odisha
    • Puducherry
    • Punjab
    • Rajasthan
    • Sikkim
    • Tamil Nadu
    • Telangana
    • Tripura
    • Uttar Pradesh
    • Uttrakhand
    • West Bengal
  • Medical Education
    • Ayush Education News
    • Dentistry Education News
    • Medical Admission News
    • Medical Colleges News
    • Medical Courses News
    • Medical Universities News
    • Nursing education News
    • Paramedical Education News
    • Study Abroad
  • Industry
    • Health Investment News
    • Health Startup News
    • Medical Devices News
    • Pharma News
      • CDSCO (Central Drugs Standard Control Organisation) News
    • Pharmacy Education News
    • Industry Perspective
  • Home
  • Dermatology
  • Dermatology News
  • Laryngeal involvement...

Laryngeal involvement in mucous membrane pemphigoid predicts poor response to rituximab: IJDVL

Written By : Dr Manoj Kumar Nayak |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2021-09-24T09:00:15+05:30  |  Updated On 24 Sept 2021 12:28 PM IST
Laryngeal involvement in mucous membrane pemphigoid predicts poor response to rituximab: IJDVL

Source- Wittenberg M, Worm M. Severe Refractory Paraneoplastic Mucous Membrane Pemphigoid Successfully Treated With Rituximab. Front Med (Lausanne). 2019;6:8. 

Wittenberg M, Worm M. Severe Refractory Paraneoplastic Mucous Membrane Pemphigoid Successfully Treated With Rituximab. Front Med (Lausanne). 2019;6:8. Published 2019 Jan 29. doi:10.3389/fmed.2019.00008

Wittenberg M, Worm M. Severe Refractory Paraneoplastic Mucous Membrane Pemphigoid Successfully Treated With Rituximab. Front Med (Lausanne). 2019;6:8. Published 2019 Jan 29. doi:10.3389/fmed.2019.00008

Wittenberg M, Worm M. Severe Refractory Paraneoplastic Mucous Membrane Pemphigoid Successfully Treated With Rituximab. Front Med (Lausanne). 2019;6:8. Published 2019 Jan 29. doi:10.3389/fmed.2019.00008

Wittenberg M, Worm M. Severe Refractory Paraneoplastic Mucous Membrane Pemphigoid Successfully Treated With Rituximab. Front Med (Lausanne). 2019;6:8. Published 2019 Jan 29. doi:10.3389/fmed.2019.00008

Wittenberg M, Worm M. Severe Refractory Paraneoplastic Mucous Membrane Pemphigoid Successfully Treated With Rituximab. Front Med (Lausanne). 2019;6:8. Published 2019 Jan 29. doi:10.3389/fmed.2019.00008

  • facebook
  • twitter
  • linkedin
  • whatsapp
  • Telegram
  • Email

Laryngeal mucous membrane pemphigoid a poor prognostic factor for rituximab treatment: IJDVL

Mucous membrane pemphigoid (MMP) is an autoimmune subepidermal bullous disease with a tendency to scar and may progress to blindness or airway obstruction. When it involves the eyes or larynx, Mucous membrane pemphigoid (MMP) tends to be refractory to conventional treatments and rituximab (RTX) has emerged as a potential therapeutic solution for MMP in the past few years. Recently a case series with a review describing the use of rituximab in MMP was described in the Clinical and Experimental Dermatology journal.

It was a case series of 4 patients of MMP who were diagnosed on the basis of typical clinical features, histology and direct immunofluorescence study.

All patients were women (mean age 72 years at the initiation of RTX treatment). Three patients had oral and laryngeal disease. Ocular and oesophageal disease were seen in one patient each. The mean duration of disease before RTX therapy was 40.75 months (range 7– 84 months). All patients had failure with at least one systemic treatment. All the patients were treated with two infusions of RTX (1 g each, given on Days 1 and 15).

In the series all 3 patients had commenced treatment with inflammatory erosive laryngeal lesions without evidence of significant scarring. 2/3 patients with laryngeal involvement had no response to RTX treatment. The third patient achieved complete remission (CR) for 2 years with subsequent relapses every 2 years which responded well to an additional RTX cycle each time.. Patient 4, who did not have laryngeal involvement achieved CR and was lost to follow-up.

A literature search was done which revealed 30 articles including 167 patients of MMP treated with RTX. Late observation endpoints (defined as outcome after at least 2 months of therapy) were noted for 144 patients, of whom 100 (69.4%) achieved CR, 26 (18%) achieved partial remission (PR) and 18 (12.5%) had no remission (NR). In total CR or PR were achieved with RTX treatment in 87.5% of patients with MMP.

Different outcomes were noted in the same patient, as certain anatomical sites responded differently to RTX treatment. Of all sites, the larynx seemed to be the most refractory to RTX treatment. In total only 40% of patients with laryngeal involvement achieved CR, whereas other sites achieved CR rates of 67%–80% (P = 0.014).

Of the 7 laryngeal MMP cases recalcitrant to RTX, 2 did not respond to additional cycles of RTX, and one remained unresponsive despite therapy with intravenous immunoglobulins (IVIG). Of the six patients with laryngeal disease who achieved CR, four were taking concomitant immunosuppressive therapy making it difficult to draw conclusions about RTX efficiency.

In conclusion rituximab is a potent therapy for MMP and relapses after RTX are frequent so maintenance therapy should be considered. Laryngeal involvement in patients with MMP may predict poor response to rituximab and in view of its serious consequences of local scarring, prompt combination therapy should be considered for these MMP cases.

Source- Baniel A, Oestreicher-Kedem Y, Peled A, Bar-Ilan E, Geller S, Sprecher E, Baum S. Laryngeal mucous membrane pemphigoid serves as a prognostic factor for poor response to treatment with rituximab. Clin Exp Dermatol. 2021 Jul;46(5):915-919. doi: 10.1111/ced.14662. Epub 2021 May 27. PMID: 33811681


MMPpemphigoidrituximabRTXlaryngealIJDVL
Source : Clinical and Experimental Dermatology journal
Dr Manoj Kumar Nayak
Dr Manoj Kumar Nayak

    MBBS

    Dr Manoj Kumar Nayak has completed his M.B.B.S. from the prestigious institute Bangalore medical college and research institute, Bengaluru. He completed his M.D. Dermatology from AIIMS Rishikesh. He is actively involved in the field of dermatology with special interests in vitiligo, immunobullous disorders, psoriasis and procedural dermatology. His continued interest in academics and recent developments serves as an inspiration to work with medical dialogues.He can be contacted at editorial@medicaldialogues.in.

    Dr. Kamal Kant Kohli
    Dr. Kamal Kant Kohli

    Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751

    Show Full Article
    Next Story

    Editorial

    Real-World Case study: Darbepoetin Alfa for Chemotherapy-Induced Anemia in Metastatic Breast Cancer - Dr Aditya Murali

    Real-World Case study: Darbepoetin Alfa for Chemotherapy-Induced Anemia in Metastatic Breast Cancer...

    Aspirin in Primary Prevention- When to Consider?

    Aspirin in Primary Prevention- When to Consider?

    Featured image representing medico legal

    What's the Role of Expert Opinion in Medical Negligence?

    7- Point Discharge Protocol for AECOPD: Time to Inculcate in Practice

    7- Point Discharge Protocol for AECOPD: Time to Inculcate in Practice

    Aspirin Use in Women Aged 40-50 with Diabetes and Hypertension: Identifying the Ideal Candidates

    Aspirin Use in Women Aged 40-50 with Diabetes and Hypertension: Identifying the Ideal Candidates

    View All

    Journal Club Today

    Real-World Case study: Darbepoetin Alfa for Chemotherapy-Induced Anemia in Metastatic Breast Cancer - Dr Aditya Murali

    Real-World Case study: Darbepoetin Alfa for Chemotherapy-Induced Anemia in Metastatic Breast Cancer...

    View All

    Health News Today

    Health Bulletin 09/ May/ 2025

    Health Bulletin 09/ May/ 2025

    View All
    © 2022 All Rights Reserved.
    Powered By: Hocalwire
    X
    We use cookies for analytics, advertising and to improve our site. You agree to our use of cookies by continuing to use our site. To know more, see our Cookie Policy and Cookie Settings.Ok