Effect of intravenous immunoglobulin with or without cytotoxic drugs on pemphigus intercellular antibodies

Lolis, Margarita S.; Toosi, Siavash; Czernik, Annette; Bystryn, Jean‐Claude

doi:10.1016/j.jaad.2010.04.001

Cited by 27 publications

(12 citation statements)

References 10 publications

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“…3 Corticosteroids were the first and only form of treatment used for this disease. Later, immunosuppressive drugs were added, following which many other treatment regimens were used, including: anti-inflammatory drugs, rituximab 4 (available in Iran), 5 intravenous immunoglobulin, [6][7][8] plasmapheresis, and immunoadsorption. 9 Unfortunately, there is still no scientifically proven 'best treatment strategy' for this disease.…”

Section: Introductionmentioning

confidence: 99%

Randomized double blind trial of prednisolone and azathioprine, vs. prednisolone and placebo, in the treatment of pemphigus vulgaris

Chams‐Davatchi

Mortazavizadeh

Daneshpazhooh

et al. 2012

Acad Dermatol Venereol

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Section: Introductionmentioning

confidence: 99%

Randomized double blind trial of prednisolone and azathioprine, vs. prednisolone and placebo, in the treatment of pemphigus vulgaris

Chams‐Davatchi

Mortazavizadeh

Daneshpazhooh

et al. 2012

Acad Dermatol Venereol

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“…[33][34][35][36] In a recent retrospective study, the coadministration of IVIG and an immunosuppressant was able to rapidly lower serum autoantibodies in 20 patients with PV and this effect was significantly enhanced than with IVIG alone. 37 As monotherapy, a recent randomized controlled trial evaluated response in patients with steroid-resistant pemphigus to IVIG dosages of 200 mg/day or 400 mg/day in comparison with a placebo. 38 The study found that patients receiving 400 mg/day had much lower disease activity and could be maintained on this treatment much longer without the need for additional therapy.…”

Section: Discussionmentioning

confidence: 99%

“…11 The September/October 2014 literature is replete with case reports of refractory PV responding to rituximab and there is growing interest in the use of IVIG. [32][33][34][35][36][37][38][39][40][41] Though no rituximab-dosing protocol is clearly superior, giving 4 weekly 375 mg/ m 2 doses allows for more rapid redosing and would be more suitable for incorporating IVIG therapy if needed. IVIG is an appropriate option when an increased risk of infection cannot be tolerated because IVIG, theoretically, also confers immunoprophylaxis.…”

Section: Discussionmentioning

confidence: 99%

The Management of Pemphigus Vulgaris in a Burn Intensive Care Unit

Miletta

Miller

Lam

et al. 2014

Journal of Burn Care & Research

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Pemphigus vulgaris is a rare, potentially fatal, autoimmune blistering disease of the skin and mucous membranes. Treatment of this disease is problematic because of a lack of high-grade, evidence-based recommendations, the side-effect profiles of the therapies available, and the extensive supportive care that afflicted patients require. The authors present the unfortunate course of a patient with severe pemphigus vulgaris who was admitted to the U.S. Army Institute of Surgical Research Burn Center, to demonstrate the potential complications of therapy. Given the patient's complex course, the authors reviewed the literature and share in this article the most up-to-date treatment recommendations for patients with pemphigus vulgaris. The authors' review of the literature supports using conventional therapy consisting of high-dose corticosteroids and an adjuvant immunosuppressant for mild to moderate cases of pemphigus vulgaris. The immunosuppresants recommended are mycophenolate mofetil, azathioprine, and cyclophosphamide, in order of preference, based on their side-effect profiles and steroid-sparing effects. For severe or recalcitrant cases of pemphigus vulgaris, the authors recommend adding rituximab as early as possible. If increased risk of infection is of particular concern, the use of intravenous immunoglobulin in place of rituximab is advised.

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“…[60] In certain studies, IVIG was tapered slowly and continued 6 monthly after inducing clinical remission. [61] IVIG also has steroid-sparing effect and helps in preventing side effects due to long-term administration of immunosuppressives. [62] IVIG is generally well tolerated though there are also a number of potential side effects.…”

Section: Intravenous Immunoglobulinsmentioning

confidence: 99%