Dapsone in the Management of Autoimmune Bullous Diseases

Piette, Evan W.; Werth, Victoria P.

doi:10.1016/j.iac.2012.04.011

Cited by 18 publications

(11 citation statements)

References 41 publications

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“…51,52 Additionally, dapsone is thought to possess antioxidant properties through its inhibition of myeloperoxidase and lysosymal enzymes, resulting in decreased production of hypochlorous acid, a potent oxidant produced by neutrophils. 51,53 Dapsone has also been shown to possess a dose-dependent inhibitory effect on the production of inflammatory cytokines such as TNF-a and IL-8 by PBMCs.…”

Section: Sulfone Derivativesmentioning

confidence: 99%

Chronic Ocular Complications of Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis: The Role of Systemic Immunomodulatory Therapy

Chang

Chodosh

Papaliodis

2016

Seminars in Ophthalmology

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Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare, but potentially blinding diseases that affect the skin and mucous membranes. Although the cutaneous manifestations tend to be self-limited and resolve without sequelae, the chronic ocular complications associated with SJS/TEN can persist despite local therapy. Poor understanding of the underlying pathophysiology and lack of a standardized clinical approach have resulted in a paucity of data in regards to suitable treatment options. Inflammatory cellular infiltration and elevated levels of ocular surface cytokines in the conjunctival specimens of affected patients give credence to an underlying immunogenic etiology. Furthermore, the presence of ongoing ocular surface inflammation and progressive conjunctival fibrosis in the absence of exogenous aggravating factors suggest a possible role for systemic immunomodulatory therapy (IMT). We review in detail the proposed immunogenesis underlying chronic ocular SJS/TEN and the possible utility of systemic IMT.

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Section: Sulfone Derivativesmentioning

confidence: 99%

Chronic Ocular Complications of Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis: The Role of Systemic Immunomodulatory Therapy

Chang

Chodosh

Papaliodis

2016

Seminars in Ophthalmology

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“…Dapsone has been used in mucocutaneous diseases (Piette and Werth, ) and is the drug of choice for treatment of dermatitis herpetiformis. A small randomized control trial (Werth et al , ) and few case reports of patients exist in the literature evaluating patients with pemphigus vulgaris (PV; including patients with oral lesions).…”

Section: Dapsonementioning

confidence: 99%

“…A small randomized control trial (Werth et al , ) and few case reports of patients exist in the literature evaluating patients with pemphigus vulgaris (PV; including patients with oral lesions). (Piette and Werth, ). Dapsone was used in combination with corticosteroids, and although improvements were reported, no definite conclusions could be drawn on the efficacy of dapsone for PV (Martin et al , ).…”

Section: Dapsonementioning

confidence: 99%

Systemic use of non‐biologic agents in orofacial diseases: other immunomodulatory agents

Georgakopoulou

Scully²

2013

Oral Diseases

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Systemic non-biologic agents have long been in clinical use in medicine -often with considerable efficacy, albeit with some adverse effects -as with all medications. With the advent of biologic agents, all of which currently are restricted to systemic use, there is a growing need to ensure which agents have the better therapeutic ratio. The non-biologic agents (NBAs) include a range of agents, most importantly the corticosteroids (steroids). Previous articles by us in this series have discussed systemic use of corticosteroids and purine synthesis inhibitors; the other immunomodulating agents (calcineurin inhibitors, thalidomide, dapsone, colchicine and cyclophosphamide) are reviewed in this final article.

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“…[16,17] It is effective against several dermatologic diseases [18,19] and relapsing polychondritis. [20] It has also been occasionally reported as a potent steroid-sparing agent in GCA, with the ability to reduce the cumulative prednisone dose and the total duration of treatment.…”

Section: Introductionmentioning

confidence: 99%

Steroid-sparing effect and toxicity of dapsone treatment in giant cell arteritis

Dalmay²,

Gondran³

et al. 2016

Medicine

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Although a glucocorticoid (GC)-sparing strategy is needed for patients with giant cell arteritis (GCA) suffering from refractory disease or serious treatment-related complications, evidence of efficacy in this setting of immunosuppressive drugs and biotherapies is lacking. Herein, we evaluated the GC-sparing effects and tolerability of addition of dapsone (DDS) to prednisone therapy in patients with GCA. We retrospectively assessed data on 18 GCA patients who received DDS as a first-line treatment (DDS-1 group) and 52 patients who received it as a second- or third-line treatment for refractory GCA, with or without excessive GC-related toxicity (DDS-2 group). Of these 70 patients, 63 belonged to an inception cohort of 478 patients, whereas the remaining 7 were referred to our department for resistant GCA. In all, 52 patients were assessable for DDS efficacy. The baseline characteristics of the DDS-1 patients were similar to those of 395 GCA patients (control group) who received prednisone alone. DDS-1 patients had a more sustained decrease in GC dose with a lower mean prednisone dose at 12 months, and they comprised higher proportions who achieved GC withdrawal within the first year, who stopped prednisone treatment, and who recovered from GCA (P < 0.001 for each variable). Patients in the DDS-2 group achieved a mean rate of prednisone reduction of 65% and a prednisone dose reduction of 16.9 ± 13.3 mg/d. The monthly decreases in the prednisone dose were 2.4 and 1.25 mg in DDS-1 and DDS-2 patients, respectively. DDS-induced side effects were recorded in 44 (64%) assessable patients. These side effects led to lowering of the DDS dose by 25 mg/d in 11 (16%) patients and permanent cessation of DDS in 14 patients (20%), due to allergic skin rash in 7, agranulocytosis in 2, icteric hepatitis in 2, and excessive hemolysis in 2 patients. DDS is a potent GC-sparing agent in GCA that should be evaluated in prospective studies. However, DDS use should be restricted to refractory GCA patients due to its toxicity, and close clinical and laboratory monitoring for 3 months is necessary.

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Dapsone in the Management of Autoimmune Bullous Diseases

Cited by 18 publications

References 41 publications

Chronic Ocular Complications of Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis: The Role of Systemic Immunomodulatory Therapy

Chronic Ocular Complications of Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis: The Role of Systemic Immunomodulatory Therapy

Systemic use of non‐biologic agents in orofacial diseases: other immunomodulatory agents

Steroid-sparing effect and toxicity of dapsone treatment in giant cell arteritis

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