Atopic dermatitis and skin diseaseAnti-CD20 (rituximab) treatment improves atopic eczema
Section snippets
Patients
In this investigator-initiated, open-label pilot study, 6 patients with severe AE according to the criteria of Hanifin and Rajka22 (4 women, 2 men; age, 19-63 years; average, 39 ± 7 years) were enrolled between October 2005 and April 2006. All patients had not adequately responded to topical corticosteroid and/or calcineurin inhibitor therapy and were candidates for, or had previously received, systemic treatment. Patient characteristics are given in Table I. The study was approved by the
Reduction of AE symptoms by rituximab
To evaluate the clinical efficacy of the treatment with rituximab, the EASI was determined. Before treatment, the mean EASI was 29.4 ± 4.3 (Table I). All patients had a significant improvement of their AE lesions within 4 weeks of treatment (Fig 2, A and B). In 2 patients, we observed a rapid improvement within the first week of treatment. All patients further improved between weeks 4 and 8. One patient developed a moderate flare-up at week 12. At weeks 16 and 24, all patients had low EASI
Discussion
The inflammatory reaction in AE is orchestrated by various immune cells. In contrast with T cells, little is known about the role of B cells in AE skin, which are also found among the dermal infiltrating cells, although in smaller numbers compared with T cells.3, 4, 5 Inspired by the excellent clinical effects obtained by selective B-cell depletion in autoimmune diseases,11, 12, 13, 14, 15, 16, 17, 18, 19, 20 we initiated this pilot study to evaluate the clinical and immunopharmacologic effects
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Supported by grants from the Swiss National Science Foundation (310000-107526) and Roche Pharma AG, Reinach.
Disclosure of potential conflict of interest: The authors have declared that they have received research support from Roche Pharma AG.