Rituximab Efficacious for Epidermolysis Bullosa Acquisita: Analysis

Key Takeaways

• Rituximab combined with prednisolone led to clinical remission in 15.7% of patients and well-controlled disease in 9.8%.

• All four patients treated with rituximab alone achieved either complete or partial remission.

Data from a new systematic review indicate rituximab (RTX) may potentially be an effective treatment option for epidermolysis bullosa acquisita (EBA).

Due to its chronic nature, management of EBA remains challenging, with remission and flare-ups common, the authors noted. Current treatment options consist of anti-inflammatory, immunosuppressive and immunomodulatory agents, with no clear single effective therapy.

Researchers review analyzed 20 studies, encompassing data from 51 patients diagnosed with EBA. Researchers examined the efficacy of RTX both as monotherapy and in combination with other immunosuppressive treatments. The most frequently used adjunct therapy was glucocorticoids, with 29 patients receiving methylprednisolone, prednisolone, or prednisone.

The primary outcome consisted of clinical remission (CR) and well-controlled (WC) disease. RTX combined with prednisolone showed the most favorable response, according to the results, with 8 patients achieving CR and 5 patients WC disease status. Four patients received RTX as monotherapy, and all achieved either CR or partial remission/control (PR/C).

"Our review highlights the relative efficacy of RTX in combination therapy and as monotherapy for the treatment of this rare condition, but more powerful research in the form of randomized clinical trials is imperative in order to obtain a more comprehensive understanding of its utility in the treatment of EBA," wrote the authors in their abstract. 

Source: Xenolpoulou D, et al. Journal of Drugs in Dermatology. 2025;24(4):387-393. Doi:10.36849/JDD.8483