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Anti-TNF Therapy for Mucous Membrane Pemphigoid

Mucous Membrane Pemphigoid, also known as Cicatricial Pemphigoid, is a serious autoimmune blistering disorder that can result in blindness and other complications as the result of scarring of the mucous membranes.  To our knowledge, there have been 2 reported uses of Etanercept for MMP in the literature. 

In the October and November editions of the Archives of Dermatology, we reported on our experiences with 4 additional patients.  Three responded to treatment with Etanercept 25mg twice a week and one who responded to Infliximab at 5mg/kg at weeks 0, 2, 6, and every 8 weeks thereafter. All of our patients had failed prior standard treatments. 

All of our patients responded rapidly and their response persists.  We did have 1 patient whose disease recurred when she stopped therapy.   Fortunately, she was able to regain control with retreatment.  Since the publication was submitted, we have treated 2 additional patients with Etanercept with the same results.

Additional cooperative, prospective studies are needed to confirm these results.  I plan to propose this study at the next meeting of the Medical Dermatology Cooperative Trials Group (http://www.meddermsociety.org/).  I hope that the use of Anti-TNF therapies for MMP will teach us something new about blistering diseases and help us to identify more effective and safer treatments for our patients who suffer from them.

Dr. Heffernan is the Associate Professor of Dermatology, Div. Chief & Residency Program Director at Wright State University, Boonshoft School of Medicine. For more information feel free to contact Dr. Heffernan at [email protected].

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