Abstract
This study investigates the frequency of infections in autoimmune blistering disease (AIBD) patients treated with rituximab and evaluates the difference in infectious complications in patients on concomitant antibiotic and/or antiviral prophylaxis. The study retrospectively reviewed 43 AIBD patients who received rituximab over a five-year interval. The patients were categorized based on prophylaxis type (antibiotic, antiviral, or both) and concomitant immunosuppression status, which we defined as treatment with an immunosuppressive medication during the time frame they were given Rituximab. Our findings suggest that concomitant immunosuppression alongside rituximab did not significantly increase the risk of developing infectious complications compared to rituximab monotherapy. Results revealed that 34.4% of patients with concomitant immunosuppression had a secondary bacterial infection, defined as bacterial complications requiring hospitalization, consistent with prior studies. Moreover, antibiotic prophylaxis did not significantly reduce infection risk in patients on rituximab, with 45.1% of these patients experiencing bacterial complications. There was an absence of pneumocystis pneumonia in the study population. Despite the small sample size and limited timeline, this study suggests that antibiotic prophylaxis may not significantly mitigate the risk of infections in AIBD patients receiving rituximab, and the risk of infection with concomitant immunosuppression with rituximab requires additional investigation for definitive causal risk.
Data availability
No datasets were generated or analysed during the current study.
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Acknowledgements
Roessler Medical Student Research Scholarship, The Ohio State University.
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Contributions
E.B. and J.K. led project inception and study design. E.B. performed thorough data collection. M.V. and E.B. performed statistical analysis, prepared figures, and drafted the final manuscript. J.K. conducted preparation and finalized edits to the current draft. All authors reviewed the final manuscript.
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was waived by the local Ethics Committee of The Ohio State University in view of the retrospective nature of the study and all the procedures being performed were part of the routine care.
IRB approval status
Approved. Buck-IRB Study ID: 2023H0024.
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The authors declare no competing interests.
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Bogdanski, E., Viveiros, M.D. & Kaffenberger, J. Frequency of infections during rituximab treatment of autoimmune blistering diseases. Arch Dermatol Res 316, 136 (2024). https://doi.org/10.1007/s00403-024-02865-w
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DOI: https://doi.org/10.1007/s00403-024-02865-w