The anti-CD20 monoclonal antibody rituximab is considered the first-line treatment in new-onset moderate-to-severe pemphigus and/or patients who do not achieve clinical remission with systemic corticosteroids and/or immunosuppressive agents. Studies have demonstrated infusion reactions, infections, and laboratory abnormalities to generally be the leading adverse event of rituximab treatment regardless of disease. We performed a systematic review to focus on the non-infectious complications of rituximab treatment that providers may not be as aware of. Our search was performed between 22 February 2019 and 10 July 2019 concentrating on autoimmune blistering diseases including pemphigus vulgaris, pemphigus vegetans, mucous membrane pemphigoid (cicatricial pemphigoid), bullous pemphigoid, linear IgA, and epidermolysis bullosa acquisita. After screening, 73 articles were used for our analysis and consisted of cohort studies, case series, case reports, and clinical trials. 1438 patients with blistering diseases were reported, of which 300 (20.8%) had adverse effects categorized as minor and major according to the Common Terminology Criteria for Adverse Events v5.0. 107 (8%) had major adverse events, and 193 patients (13.6%) had minor adverse events. Of major adverse events, 14.5% were non-infectious and represented cardiovascular, gastrointestinal, neoplastic processes, cutaneous, and renal processes. Of minor adverse events, 23% were neither infectious nor infusion reactions, and included laboratory abnormalities, altered mental status, and cutaneous disease. Despite the safety of rituximab for autoimmune blistering diseases, its use may be associated with significant adverse effects including but not limited to infectious disease. Thus, close monitoring of patients treated with rituximab is recommended.

ESDR030 - Non-infectious Complications of Rituximab during Treatment for Autoimmune Blistering Diseases

50th Annual Meeting of the European Society for Dermatological Research. VIRTUAL MEETING