Oral cyclophosphamide without corticosteroids to treat mucous membrane pemphigoid

Munyangango, E.M.; Roux–Villet, C. Le; Doan, Serge; Pascal, F.; Soued, I.; Alexandre, M.; Heller, Michel; Lièvre, Nicole; Aucouturier, Françoise; Caux, F.; Laroche, Liliane; Prost-Squarcioni, Catherine

doi:10.1111/bjd.12041

Cited by 46 publications

(40 citation statements)

References 40 publications

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“…dapsone, sulfasalazine or topical agents). 69 After 52 weeks, a response rate of 69% with a median time to disease control of 8 weeks was observed. 69 Extra-ocular lesions took longer to regress than ocular inflammation.…”

Section: Mucous Membrane Pemphigoid (Mmp) Including Ocular and Extraomentioning

confidence: 96%

Cyclophosphamide in dermatology

Kim

Chan

2016

Aust J Dermatology

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Cyclophosphamide is a chemotherapeutic agent which was first discovered in experimental tumours in rats, and it has since been widely used to treat malignancies and severe manifestations of various auto-immune diseases. High-dose chemotherapy and continuous daily oral regimens are associated with significant toxicity profiles, but i.v. pulsed regimens have lowered the rates of adverse effects in rheumatological studies. Cyclophosphamide has been shown to be useful in the treatment of severe autoimmune conditions due to its powerful immunosuppressive ability; however, it remains a relatively underused modality in dermatology. This article reviews the current literature on cyclophosphamide and its clinical applications in dermatology.

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Section: Mucous Membrane Pemphigoid (Mmp) Including Ocular and Extraomentioning

confidence: 96%

Cyclophosphamide in dermatology

Kim

Chan

2016

Aust J Dermatology

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“…Cyclophosphamide (CPM) is an alkylating agent widely used for the treatment of malignancies such as breast cancer, 1 multiple myeloma, 2 renal diseases including nephrotic syndrome refractory to corticosteroid and focal segmental glomerulonephritis, and this drug can be used in the treatment of multiple rheumatic diseases, [3][4][5] including cicatricial pemphigoid (also called pemphigoid mucous membrane), 4 rheumatoid arthritis, 5 juvenile dermatomyositis, 6 systemic sclerosis, 7,8 interstitial lung disease, 7 lupus vasculopathy, 9 systemic vasculitis, and refractory treatment of lupusassociated thrombocytopenic purpura. 10 In addition to other indications of cyclophosphamide, the treatment of neuromyelitis optica can also be included.…”

Section: Introductionmentioning

confidence: 99%

Cyclophosphamide Administration Routine in Autoimmune Rheumatic Diseases: A Review

Teles

Souza

Лима³

et al. 2018

Nefrologiâ (St.-Peterbg.)

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r e v b r a s r e u m a t o l . 2 0 1 7;5 7injetáveis. O trabalho objetivou a estruturação de uma rotina do uso de ciclofosfamida, bem como a criação de um documento de orientaç ões farmacoterapêuticas para o paciente. A rotina foi esquematizada em três fases, a pré-quimioterapia, a administração da ciclofosfamida e a pós-quimioterapia, que levaram em consideração os medicamentos que devem ser administrados antes e depois da ciclofosfamida para prevenção aos efeitos adversos, incluindo náusea e cistite hemorrágica. As reaç ões adversas podem alterar os exames laboratoriais e a rotina incluiu manejo clínico para alteração clínica dos leucócitos, das plaquetas, dos neutrófilos e do sódio incluindo o ajuste de dose de ciclofosfamida em caso de insuficiência renal. A ciclofosfamida é responsável por outras reaç ões adversas raras, mas sérias, como hepatotoxicidade, hiponatremia severa e falência cardíaca. Outras reaç ões adversas incluem perda de cabelo, amenorreia e menopausa. A rotina foi composta também por orientaç ões ao paciente pós-quimioterapia. A compatibilidade dos medicamentos injetáveis com o veículo foi descrita, bem como o tempo de estabilidade e o tempo de infusão.A rotina visou ao uso racional da ciclofosfamida e prevenir os efeitos adversos e os episódios de recidiva, os quais podem onerar o sistema de saúde.

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“…[7][8][9] Precisely scoring the ocular and laryngeal involvement would be ideal for monitoring and making therapeutic decisions. However, this excess detail had to be balanced with ease of completion in clinical and research settings for dermatologists and whether such detail would provide additional beneficial information to clinical decision making is currently uncertain.…”

Section: Mmp Disease Activity Indexmentioning

confidence: 99%

Definitions and outcome measures for mucous membrane pemphigoid: Recommendations of an international panel of experts

Murrell¹,

Marinović²,

Caux³

et al. 2015

Journal of the American Academy of Dermatology

130

105

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Mucous membrane pemphigoid encompasses a group of autoimmune bullous diseases with a similar phenotype characterized by subepithelial blisters, erosions, and scarring of mucous membranes, skin, or both. Although knowledge about autoimmune bullous disease is increasing, there is often a lack of clear definitions of disease, outcome measures, and therapeutic end points. With clearer definitions and outcome measures, it is possible to directly compare the results and data from various studies using meta-analyses. This consensus statement provides accurate and reproducible definitions for disease extent, activity, outcome measures, end points, and therapeutic response for mucous membrane pemphigoid and proposes a disease extent score, the Mucous Membrane Pemphigoid Disease Area Index.

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Oral cyclophosphamide without corticosteroids to treat mucous membrane pemphigoid

Abstract: CYC without corticosteroids had rapid efficacy in patients with severe refractory MMP and was safe.

Cited by 46 publications

References 40 publications

Cyclophosphamide in dermatology

Cyclophosphamide in dermatology

Cyclophosphamide Administration Routine in Autoimmune Rheumatic Diseases: A Review

Definitions and outcome measures for mucous membrane pemphigoid: Recommendations of an international panel of experts

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