Analysis: Fewer Than Half of Patients With Multisite Mucous Membrane Pemphigoid Achieve Complete Remission

A retrospective study published in JAMA Dermatology indicatedfewer than half of patients with multisite mucous membrane pemphigoid (MMP) achieved simultaneous complete remission across all affected sites, despite widespread improvement with treatment.

Researchers at the University of Texas Southwestern Medical Center in Dallas evaluated 77 patients with immunopathologically confirmed MMP involving at least two anatomic sites. The single-center study included patients treated between January 2013 and January 2025, with at least 12 months of posttreatment follow-up.

The cohort had a median age of 66 years, 71% were female, and 88% had high-risk disease. Oral involvement was most prevalent (95%), followed by ocular (66%) and nasal (49%) disease.

Oral and Ocular Disease Complicate Long-Term Remission

Overall, 35 patients (45%) achieved multisite complete remission (mCR), defined as concurrent remission across all affected sites, after a median of 32 months. Although all patients demonstrated improvement and 83% achieved complete remission at one or more sites, durable drug-free remission occurred in only 9%.

Relapses occurred in 44% of patients achieving site-level remission, most frequently involving oral (64%) and ocular (50%) mucosa. Cutaneous disease achieved remission more rapidly than several mucosal sites.

Rituximab-containing regimens and JAK inhibitors were associated with substantial clinical improvement, although treatment-related serious adverse events were reported.

"In this cohort study, fewer than half of patients with multisite MMP achieved simultaneous multisite remission despite high rates of site-specific response," the authors concluded. "Oral and ocular diseases were the primary drivers of persistent activity and relapse, supporting greater emphasis on site-directed assessment and management."

Source

McAleer et al. JAMA Dermatology, October 28, 2026.