Assessment of the adjuvant effect of tacrolimus in the management of pemphigus vulgaris: A randomized controlled trial

Abstract

Tacrolimus effects are comparable to azathioprine as pemphigus vulgaris adjuvant treatment, also it has less severe side effects. Trial registration No. IRCT2012073010450N1 available at www.IRCT.ir.

Treatment of Pemphigus Vulgaris and Pemphigus Foliaceus: A Systematic Review and Meta-Analysis

“…In the sole trial comparing tacrolimus and azathioprine, no benefit was noted in CR rate, cumulative glucocorticoid dose, time to achieve disease control, rate of withdrawal due to adverse events, or rate of death [20].…”

“…The follow-up period ranged from 1 to 60 months. The characteristics and main efficacy results of the 20 trials are displayed in Table 1 [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27]. The majority of studies included patients with newly diagnosed disease [8, 10-12, 14, 16, 18, 21] or a combination of newly diagnosed disease and recurrent disease [9,13,19,20,22,25,27].…”

“…One trial compared prednisolone with adjuvant azathioprine or tacrolimus [20]; 46 participants were included, all with PV. There was no between-group difference in CR rate (RR 0.95, 95 % CI 0.78-1.17) or cumulative glucocorticoid dose (mean difference -25 mg, 95 % CI -109.64 to 59.64).…”

Multinational Evaluation of Mycophenolic Acid, Tacrolimus, Cyclosporin, Sirolimus, and Everolimus Utilization

“…Several initiatives recently enacted by the Australian government, as well as cheaper generic availability of pharmaceuticals after patent expiry, have introduced cost-savings measures and these introduce uncertainty about future pricing structures and PBS expenditures. However, by considering the increasing number of kidney transplant operations, functioning kidney transplants in the community and potential for widening of the subsidized indications, particularly for mycophenolate [47][48][49], tacrolimus [50] and everolimus [51][52][53], immunosuppressant expenditure will continue to rise into the future. It is not likely that generic formulations …”

Tacrolimus reverses the pemphigus vulgaris serum-enhanced expression of desmoglein in HaCaT cells

“…There are also two case reports on the successful use of systemic tacrolimus for recalcitrant PV unresponsive to prednisolone, azathioprine (AZA), mycophenolate mofetil (MMF), dapsone, and cyclophosphamide (CP) [6]. A randomized controlled trial demonstrated that tacrolimus effects are comparable to AZA as PV adjuvant treatment, although with less severe side effects [7]. Takae et al used a pemphigus mouse model to evaluate various immunosuppressive therapies and reported the suppressive effect of tacrolimus on the production of anti-Dsg3 IgG [8].…”