B-cell-activating factor and A proliferation-inducing ligand (BAFF/APRIL) blockade with telitacicept in pemphigus foliaceus: two cases

Telitacicept, a TACI-Fc fusion that neutralizes BAFF/APRIL, was administered weekly (160 mg) to two women with pemphigus foliaceus who declined systemic corticosteroids and conventional immunosuppressants. Rapid disease control ensued (Pemphigus Disease Area Index score of 0 by weeks 8–10) with normalized anti-Dsg1 titres and sustained remission over 6 months; treatment was well tolerated without interruption. These preliminary observations, which represent, to our knowledge, the first use of telitacicept in pemphigus foliaceus, support BAFF/APRIL blockade as a potential steroid-sparing strategy.