Targeted therapies in pemphigus vulgaris: Emerging horizons beyond rituximab. (PubMed, J Eur Acad Dermatol Venereol) - Oct 7, 2026 - "Next-generation anti-CD20 monoclonal antibodies-ofatumumab, ocrelizumab, obinutuzumab and veltuzumab-offer enhanced effector functions, reduced immunogenicity and subcutaneous delivery for rituximab-intolerant or HACA-positive patients, though evidence remains at case and cohort level. BAFF/APRIL pathway inhibitors, principally telitacicept and ianalumab, target the B-cell survival axis elevated post-rituximab and show promise in pemphigus case reports and extrapolated phase 2/3 systemic lupus erythematosus data. Bruton tyrosine kinase inhibitors, particularly rilzabrutinib, demonstrated rapid disease control and meaningful steroid-sparing effects in phase 2 trials, though the pivotal PEGASUS phase 3 trial did not meet its primary endpoint. FcRn antagonists, led by efgartigimod, achieve 60-70% reduction in circulating IgG within weeks without broad immunosuppression; the phase 3 ADDRESS trial missed its primary endpoint, likely due to corticosteroid confounding..."
Journal • Review • Dermatology • Immunology • Inflammatory Arthritis • Lupus • Pemphigus Vulgaris • Systemic Lupus Erythematosus
|
|
Dedee Murrell; Rhea Ahuja
|