Anti-BP180 NC16A IgG Titres as an Indicator of Disease Activity and Outcome in Asian Patients with Bullous Pemphigoid

• Published in: Annals of the Academy of Medicine, Singapore Vol. 44; no. 4; pp. 119 - 126
• Main Authors: Cai, Sophie C S, Lim, Yen Loo, Li, Wenyun, Allen, John Carson, Chua, Sze Hon, Tan, Suat Hoon, Tang, Mark B Y
• Format: Journal Article
• Language: English
• Published: Singapore 01.04.2015
• Subjects: Adult; Aged; Aged, 80 and over; Antibodies, Anti-Idiotypic - blood; Asian People; Autoantibodies - blood; Autoantigens - blood; Collagen Type XVII; Disease Progression; Enzyme-Linked Immunosorbent Assay; Female; Humans; Male; Middle Aged; Non-Fibrillar Collagens - blood; Outcome Assessment, Health Care; Pemphigoid, Bullous - diagnosis; Pemphigoid, Bullous - ethnology; Pemphigoid, Bullous - immunology; Predictive Value of Tests; Prospective Studies; Singapore; Singapore
• ISSN: 0304-4602; 2972-4066; 0304-4602
• DOI: 10.47102/annals-acadmedsg.V44N4p119

Anti-BP180 IgG titres were observed to parallel disease activity in case series of bullous pemphigoid (BP). This study aimed to examine whether anti-BP180 titres are an indicator of disease severity, clinical course and outcome in Asian patients with BP. This was a prospective observational study conducted between March 2005 and March 2008 in the Immunodermatology Clinic at the National Skin Centre, Singapore. Disease activity and anti-BP180 IgG titres were measured 4-weekly for 12 weeks and during disease flares and clinical remission. Associations between anti-BP180 titres and disease activity, disease flare, clinical remission and cumulative prednisolone dose were examined. Thirty-four patients with newly diagnosed BP were recruited. Median follow-up duration was 3 years. Notable correlations between disease activity and anti-BP180 titres were at baseline (r = 0.51, P = 0.002), and disease flare (r = 0.85, P <0.001). Lower titres at Week 12 were associated with greater likelihood of clinical remission (P = 0.036). Post hoc, patients with anti-BP180 titres above 87.5 U/mL at time of diagnosis who reached remission within 2 years of diagnosis received significantly higher cumulative doses (mg/kg) of prednisolone (median, 72.8; range, 56.5 to 127.1) than those with titres <87.5 U/mL (median, 44.6; range, 32.5 to 80.8); P = 0.025). Anti-BP180 titres may be a useful indicator of disease activity at time of diagnosis and at disease flare. Lower titres at Week 12 may predict greater likelihood of clinical remission. Titres above 87.5 U/mL at time of diagnosis may suggest the need for higher cumulative doses of prednisolone to achieve remission within 2 years.