Curative treatment for pemphigus

Pasricha, J. S.

doi:10.1001/archderm.132.12.1518

Cited by 9 publications

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“…Many open studies differing in design, criteria, regimen, and concomitant drugs evaluated CS pulse therapy in pemphigus. [4][5][6][7][8][9][10][11][12][13][14][15][16][17] For CS pulse therapy, 500-to 1000-mg shots of methylprednisolone acetate or, most often, 100-to 200-mg shots of dexamethasone are given intravenously divided during 3 consecutive days per month.…”

Section: P Emphigus Vulgaris Is a Po-mentioning

confidence: 99%

Randomized Controlled Trial of Adjuvant Oral Dexamethasone Pulse Therapy in Pemphigus Vulgaris

Mentink¹,

Mackenzie²,

Tóth³

et al. 2006

Arch Dermatol

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To determine the therapeutic effect of adjuvant dexamethasone pulse therapy when given in addition to conventional treatment of pemphigus vulgaris.Design: A randomized, placebo-controlled trial.Setting: International European, multicenter outpatient and inpatient study.Patients: Of the 20 enrolled patients, 11 were randomized to the dexamethasone pulse (DP) group and 9 to the placebo pulse (PP) group.Interventions: Oral dexamethasone in 300-mg pulses or PPs 3 days per month. During the intervention, the DP and PP groups received conventional treatment with prednisolone, 80 mg/d, which was tapered across 19 weeks, and azathioprine sodium, 3 mg/kg per day, until the end of the study. Monthly pulses were continued until prednisolone treatment was tapered to 0 mg.Main Outcome Measures: Number of patients in remission, time to and duration of remission, cumulative prednisolone dose, and occurrence of adverse events during 1 year of follow-up.Results: Eight of the 11 DP-treated patients and all 9 PP-treated patients achieved remission. Mean time to remission was 173 days with DP and 176 days with PP. The mean duration of remission within the first year was 151 days for DP and 141 days for PP. Mean cumulative prednisolone dose was 5300 mg for DP and 4882 mg for PP. Weight gain (Ͼ5% of baseline) occurred in 8 DPtreated patients compared with 1 PP-treated patient (PϽ.01).We found no statistically significant difference (PϾ.05) of an adjuvant effect of DP on remission of pemphigus vulgaris. Conclusion:In patients with new pemphigus vulgaris disease activity, there was no benefit of oral DP therapy given in addition to conventional treatment.

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Section: P Emphigus Vulgaris Is a Po-mentioning

confidence: 99%

Randomized Controlled Trial of Adjuvant Oral Dexamethasone Pulse Therapy in Pemphigus Vulgaris

Mentink¹,

Mackenzie²,

Tóth³

et al. 2006

Arch Dermatol

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Inflammatory Dermatoses

2011

British Association of Dermatologists' Management Guidelines

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Dexamethasone pulse therapy in pemphigus

Toth

Meer

Jonkman

2002

Acad Dermatol Venereol

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Pulse therapy with high-dose glucocorticoids was introduced 20 years ago as a treatment modality for autoimmune disease and transplant rejection. The most popular dermatological indication for pulse therapy is severe pemphigus. We reviewed the sequelae of 14 patients with pemphigus who were treated by pulse therapy. Seven of them reached complete remission, although three of them needed a new pulse course due to disease flare-up. Adverse events were minor and confined to 60% of all patients: temporary facial flushing during pulse administration, sleep disturbances during the first night after pulse administration, and mood changes occurred during the week of pulse therapy. The study showed the possibility of oral instead of an intravenous mute of dexamethasone pulse administration, which makes double-blind placebo-controlled trials ethically feasible. Fifty per cent of the patients reached complete remission. This retrospective study does not allow claims on the steroid-sparing effect.

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Curative treatment for pemphigus

Cited by 9 publications

References 0 publications

Randomized Controlled Trial of Adjuvant Oral Dexamethasone Pulse Therapy in Pemphigus Vulgaris

Randomized Controlled Trial of Adjuvant Oral Dexamethasone Pulse Therapy in Pemphigus Vulgaris

Inflammatory Dermatoses

Dexamethasone pulse therapy in pemphigus

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