Clinical characteristics, mortality, and prognostic factors for bullous pemphigoid in a Thai population

Amonchaisakda, Nuntouchaporn; Aiempanakit, Kumpol

doi:10.1097/md.0000000000022850

Cited by 9 publications

(5 citation statements)

References 32 publications

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“…The latter, reported a lower 3‐year mortality rate compared to our result (43%). In opposition, data from the Thailand demonstrated a higher 3‐year mortality (55,7%) in comparison to our result; Still, the median age of their cases was older (82 years) than ours (72 years) 12 . Mortality rate data from Africa was not reported.…”

Section: Discussioncontrasting

confidence: 99%

“…However, little data regarding the 3‐ or 5‐year mortality for BP cases are available. In several studies, the 3‐year mortality rate has been mentioned in the range of 20% to 45% and 5‐year mortality rate in the range of 30% to 60.8% 3,12,13 . The explanation for these vast discrepancies in mortality rates among different nations is unclear.…”

Section: Introductionmentioning

confidence: 99%

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Mortality and prognostic factors of Bullous Pemphigoid in a Moroccan population

Titou

Hjira

2022

Aust J Dermatology

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Background: Bullous pemphigoid is a common autoimmune blistering skin disease that is significantly associated with a high rate of morbidity and mortality.Objective: Our aim was to determine the 1-, 2-and 3-year mortality rate and standardized mortality ratio of BP in Moroccan patients, as well as to identify risk factors that influence survival both in the 1st and 3rd year of follow-up.Methods: All patients with BP diagnosed between January 2008 and December 2017 in a tertiary referral centre at the Mohammed V Military Hospital in Morocco were included retrospectively. Results:The 1-year, 2-year and 3-year mortality rates of the cases were 25.8%, 32.3% and 43%, respectively. The median age of onset was 72 years (range, 64 ∼ 80 years), and 51 (54.8%) patients were men. The standardized mortality ratio of patients with BP was 2.6 times higher than that of age-and sex-matched members of the general Moroccan population. Besides advanced age, the presence of diabetes mellitus at the time of diagnosis was associated with increased 3-year mortality in multivariate analysis. Conclusion:This is the first study analysing the mortality rate of bullous pemphigoid in Morocco. Our findings confirm a high mortality rate for BP patients compared with the expected mortality rate for age-and sex-adjusted general Moroccan population. Risk factors for increased 3-year mortality include advanced age at the time of diagnosis and diabetes mellitus.

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Section: Discussioncontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Mortality and prognostic factors of Bullous Pemphigoid in a Moroccan population

Titou

Hjira

2022

Aust J Dermatology

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“…Studies in the United States have consistently indicated an increased risk of hospitalization for pemphigus and pemphigoid patients of Asian descent 2,3,5 . Our study aligns with other related research 6–8 in identifying hypertension and diabetes mellitus as the predominant comorbidities in patients with AIBDs. Furthermore, a comprehensive population‐based study associated neurological comorbidities with conditions such as BP, PV and epidermolysis bullosa acquisita 9 …”

Section: Discussionsupporting

confidence: 88%

Hospitalization and mortality in Asian autoimmune bullous dermatosis patients: A 17‐year retrospective study

Amonchaisakda,

Rujitharanawong,

Tuchinda

et al. 2024

Experimental Dermatology

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Limited data exist on the factors associated with hospitalization and mortality in Asian inpatients with autoimmune bullous dermatoses (AIBDs). This study aimed to elucidate the risk factors affecting hospitalization and mortality rates in Asian patients with AIBDs. A retrospective analysis of patients with AIBDs treated at Siriraj Hospital during a 17‐year period was performed using the International Classification of Diseases 10th revision codes. The characteristics of inpatients and outpatients were compared, and mortality rates and associated factors were identified. The study included 360 AIBD patients (180 inpatients, 180 outpatients). Inpatients were significantly younger than outpatients. The identified risk factors for hospitalization were malignancy (odds ratio [OR] 2.83, 95% confidence interval [CI] 1.13–8.04; p = 0.034), moderate to severe disease (OR 2.52, 95% CI 1.49–4.34; p < 0.001), systemic corticosteroid use ≥15 mg/day (OR 2.27, 95% CI 1.21–4.41; p = 0.013) and oral cyclophosphamide treatment (OR 9.88, 95% CI 3.82–33.7; p < 0.001). Kaplan–Meier analysis revealed mortality rates of 26%, 36% and 39% for inpatients with pemphigus at 1, 3 and 5 years, respectively. For inpatients with pemphigoid, the corresponding rates were 28%, 38% and 47%. Infections, particularly pneumonia, were the predominant cause of death in both conditions. This study confirmed that both Asian ethnicity and healthcare disparities may be correlated with adverse outcomes in patients with AIBDs. Pemphigus mortality rates were substantially greater in Asian patients than in Caucasian patients. Continuous monitoring of factors contributing to hospitalization and mortality is imperative to improve treatment outcomes.

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“…15 A study in Songkhla, Thailand found that the 1-year, 3-year and 5-year overall mortality rates of pemphigoid patients were 28.1% , 55.7% and 71.9%. 16 The 1-year, and 3-year overall mortality rates of pemphigoid patients were 25.8% and 43.0% from a study in Morocco. 17 For pemphigus, the 1-, 2-, and 5-year overall survival rates were 92%, 88%, and 77% in a French multicenter study with 249 patients.…”

Section: Discussionmentioning

confidence: 94%

Clinical Characteristics and Survival of Pemphigoid and Pemphigus Patients in a Thai Population

Insan,

Tuekhruea,

Nettrakun

et al. 2024

Siriraj Med J

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Objective: Pemphigoid and pemphigus are skin diseases with high morbidity and mortality. The research aims to study the clinical presentations, comorbidities, and medications used prior to diagnosis, as well as the survival rates and prognostic factors for pemphigoid and pemphigus patients. Materials and Methods: The cohort study was conducted on retrospective data of patients who were treated at Naresuan University Hospital between 1 October 2012 and 30 September 2022. Results: There were 30 pemphigoid patients and 44 pemphigus patients. Pemphigoid patients were on average older than pemphigus patients (76 years vs 52 years), have more skin blisters, and less oral cavity lesions. Neurological disease increases risk of being diagnosed as a bullous pemphigoid (odds ratio=4.6, p-value =0.051). After adjustment by neurologic disease and age at diagnosis, pemphigoid was not significantly associated with the use of any medications. The survival rate of pemphigus was 91.1% at 1 year and 82.2% at 5 years, while the survival rate of pemphigoid was 69.9% at 1 year, and 47.7% at 5 years. In multivariable Cox regression analysis, there was worse prognosis among pemphigoid and pemphigus patients that have comorbidity disease (adjusted HR= 3.13, p-value=0.057) and were older than 70 years (adj HR= 6.93, p-value=0.015). Conclusion: Clinical characteristics of bullous pemphigoid and pemphigus were different such as age of onset, presence of blister and oral lesion. Neurological disease was a risk factor for developing bullous pemphigoid than pemphigus. Survival of pemphigoid patients was worse than pemphigus patients. However, this finding could be confounded by older age of pemphigoid patients.

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Clinical characteristics, mortality, and prognostic factors for bullous pemphigoid in a Thai population

Cited by 9 publications

References 32 publications

Mortality and prognostic factors of Bullous Pemphigoid in a Moroccan population

Mortality and prognostic factors of Bullous Pemphigoid in a Moroccan population

Hospitalization and mortality in Asian autoimmune bullous dermatosis patients: A 17‐year retrospective study

Clinical Characteristics and Survival of Pemphigoid and Pemphigus Patients in a Thai Population

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