Prognostic clinical factors associated with remission and relapse in bullous pemphigoid

Lee, J. H.; Kim, T. H.; Park, S. H.; Han, Kyunghwa; Kim, S. C.

doi:10.1111/jdv.13839

Cited by 6 publications

(3 citation statements)

References 11 publications

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“…Negative reaction to BP180 and BP230 ELISA might be a predictive sign of non-relapse. Overall, our study contained a small number of samples, although the frequency of relapse (34%) in our study was similar to that reported previously in Europe ( 12 , 13 ) and Asia ( 24 ). Therefore, further study with larger sample sizes will be required.…”

Section: Discussionsupporting

confidence: 87%

High Index Values of Enzyme-Linked Immunosorbent Assay for BP180 at Baseline Predict Relapse in Patients With Bullous Pemphigoid

et al. 2018

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Bullous pemphigoid (BP) presenting with erythema plaques and tense blisters is the most frequent autoimmune bullous disease. Immunologically, BP is characterized by the presence of circulating anti-epidermal basement membrane zone (BMZ) antibodies. The autoantigens in BMZs targeted by patient's antibodies are mainly BP180 (type XVII collagen) and BP230. Previous reports have indicated that IgG to the immunodominant region of BP180 in BP, 16th non-collagenous domain (NC16A), and anti-BP180NC16A IgE are related to disease activity. In the cytokine profile, serum levels of IL-6, TNF-α, IL-15, and CCL18 were associated with the severity or activity of the disease. Blood eosinophilia is seen frequently, especially in severe cases. These biomarkers are helpful to evaluate efficacy of treatment and disease severity. Due to the high frequency of disease relapse, prediction of relapse at initiation of treatment (baseline) must be beneficial for clinicians. Therefore, we evaluated biomarkers anti-BP180 IgG (BP180 ELISA), anti-BP230 IgG (BP230 ELISA), peripheral eosinophils, and serum IgE at baseline between BP patients with (n = 16) and without (n = 31) relapse. We found significantly higher index values of BP180 ELISA in the relapse group, whereas no significant difference was found in BP230 ELISA, peripheral eosinophils, and serum IgE. This study indicated that a high index value of BP180 ELISA (cutoff value, 53.09 U/mL; sensitivity, 81.3%; specificity, 48.4%) at baseline may predict relapse in patients with BP. This may help clinicians treating BP patients in decision-making regarding duration and intensity of treatment.

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Section: Discussionsupporting

confidence: 87%

High Index Values of Enzyme-Linked Immunosorbent Assay for BP180 at Baseline Predict Relapse in Patients With Bullous Pemphigoid

et al. 2018

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“…Among BP patients, 73.8-85% were reported to be treated with systemic corticosteroid [15][16][17] and relapse rates were reported to be 15-53%. 3,5,[18][19][20][21][22][23] This clearly contrasts with pemphigus patients; we recently reported that 62% of pemphigus patients experienced relapse at least once and all of them had been treated with oral PSL. 24 In Japanese guidelines for pemphigoid management, oral PSL (0.5-1 mg/kg) is recommended as a first-line treatment for moderate to severe BP.…”

Section: Discussionmentioning

confidence: 93%

“…In our study, 37.2% of patients were treated without oral PSL and the relapse rate was less than 10% in those patients (Tables 1 and 4). Among BP patients, 73.8–85% were reported to be treated with systemic corticosteroid 15–17 and relapse rates were reported to be 15–53% 3,5,18–23 . This clearly contrasts with pemphigus patients; we recently reported that 62% of pemphigus patients experienced relapse at least once and all of them had been treated with oral PSL 24 …”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics and outcomes of bullous pemphigoid patients with versus without oral prednisolone treatment

Ujiie

Iwata

Yoshimoto

et al. 2021

The Journal of Dermatology

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Bullous pemphigoid (BP) varies in severity and stratified treatments are needed. However, there are no definitive standards for choosing appropriate treatments. To elucidate the factors involved in choosing treatments and the clinical outcomes of BP, we retrospectively reviewed the clinical records of 78 BP patients at a single center. Of the 78 patients, 49 (62.8%) were treated with oral prednisolone (PSL) and 29 (37.2%) were treated without PSL. The patients with older age, lower Bullous Pemphigoid Disease Area Index (BPDAI), and/or lower anti‐BP180NC16a antibody titer at onset tended to be treated without oral PSL. Notably, only 9.1% patients without PSL experienced relapse, whereas 36.7% patients with oral PSL experienced relapse when the PSL was around 0.1 mg/kg. It suggests that the patients with mild disease severity could be well controlled without oral PSL. Receiver–operator curve analysis demonstrated that the cut‐off value for the use of oral PSL was 31 for total BPDAI and was 7 for BPDAI skin urticaria/erythema, with a high (>0.9) area under the curve. Notably, none of the patients who were negative for the anti‐BP180NC16a antibody at onset experienced relapse even though they were treated without PSL. In conclusion, in BP patients who were negative for anti‐BP180NC16a antibody at onset, with a total BPDAI score of less than 31 or with an urticaria/erythema score of less than 7 can be treated without PSL. When the PSL is tapered to around 0.1 mg/kg, we should carefully monitor the patients to detect relapse.

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Application of Platelet-Rich Plasma in Other Aspects of Plastic and Aesthetic Surgery

Wei,

Huang,

Cheng

2023

Platelet-Rich Plasma in Tissue Repair and Regeneration

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Prognostic clinical factors associated with remission and relapse in bullous pemphigoid

Abstract: This study suggests BP patients who are older and have no admission history tend to achieve remission.

Cited by 6 publications

References 11 publications

High Index Values of Enzyme-Linked Immunosorbent Assay for BP180 at Baseline Predict Relapse in Patients With Bullous Pemphigoid

High Index Values of Enzyme-Linked Immunosorbent Assay for BP180 at Baseline Predict Relapse in Patients With Bullous Pemphigoid

Clinical characteristics and outcomes of bullous pemphigoid patients with versus without oral prednisolone treatment

Application of Platelet-Rich Plasma in Other Aspects of Plastic and Aesthetic Surgery

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