Bullous pemphigoid (BP) is the world’s most prevalent autoimmune blistering skin condition. Systemic corticosteroids are considered the cornerstone of therapy; nonetheless, they can induce severe adverse effects and treatment failures, necessitating the adoption of other therapeutic modalities with higher safety profiles. Rituximab and omalizumab are innovative biologic medicines that have been used to treat BP in recent years, however, data on their efficacy in the condition is sparse. For this study, researchers wanted to conduct a comprehensive evaluation of the current literature on the use of rituximab and omalizumab for the treatment of BP in order to assess their safety and effectiveness.

A systematic assessment of all papers evaluating patients with high blood pressure who were treated with rituximab or omalizumab was conducted. Clinical response was the primary endpoint, with adverse events and recurrence rate as secondary outcomes.

About 35 papers were included in the systematic review (84 patients: 62 receiving rituximab and 22 receiving omalizumab). Before getting the biological therapy, 61 of 63 patients had not obtained disease control with systemic corticosteroids. Rituximab and omalizumab had complete response rates of 85 and 84%, respectively. The recurrence rate with rituximab was much lower (29%) compared with omalizumab (80%). The mean time to recurrence was 10.2 and 3.4 months, respectively, and adverse effects occurred in 24% and 20% of the patients.