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

Abstract

Azathioprine helps to reduce prednisolone dose in long-run.

Treatment of Pemphigus Vulgaris and Pemphigus Foliaceus: A Systematic Review and Meta-Analysis

“…Azathioprine was found to have a steroid-sparing effect compared with oral prednisolone alone in a meta-analysis that included 116 participants [10,11], and compared to adjuvant MMF in a meta-analysis that included 99 participants [10,19]. Azathioprine-associated CR rates, time to disease control, rate of withdrawal due to adverse events, and rate of death were similar to those for oral glucocorticoid alone [10,11] or oral glucocorticoids combined with MMF [10,19].…”

“…2, p = 0.16, I 2 = 50 %). Azathioprine had no effect on time to disease control (HR 0.90, 95 % CI 0.50-1.62) or relapse rate (RR 0.67, 95 % CI 0.27-1.62), reported in one trial [11]. There were no deaths in either trial [10,11].…”

“…Two trials compared prednisolone with or without adjuvant azathioprine [10,11]. They included a total of 116 participants, all with PV.…”

“…Nine trials [10][11][12][13][14][15][16][17][18] compared the efficacy of oral glucocorticoid alone or combined with an adjuvant agent. Two trials compared prednisolone with or without adjuvant azathioprine [10,11].…”

“…The follow-up period ranged from 1 to 60 months. The characteristics and main efficacy results of the 20 trials are displayed in Table 1 [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27]. The majority of studies included patients with newly diagnosed disease [8, 10-12, 14, 16, 18, 21] or a combination of newly diagnosed disease and recurrent disease [9,13,19,20,22,25,27].…”