The use of sulfasalazine and pentoxifylline (low-cost antitumour necrosis factor drugs) as adjuvant therapy for the treatment of pemphigus vulgaris: a comparative study

El-Darouti, Mohammad Ali; Marzouk, Salonas A.; Hay, Rania Abdel; Tawdy, Amira El; Fawzy, Marwa M.; Leheta, Tahra M; Gammaz, Hatim Abd El-Khalik; Gendy, N. Al

doi:10.1111/j.1365-2133.2009.09208.x

Cited by 40 publications

(29 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This could be attributed to the synergistic effect of the two used immunosuppressive modalities; pulse steroid therapy and cyclophosphamide leading to the rapid dampening of the Th2 response and IL-4 production and thereby decreasing the IgG4 production. In addition, both drugs directly inhibit antibody production by B cells [11]. Furthermore, the use of two anti-tumor necrosis factor (TNF) a drugs; sulphasalazine and pentoxifylline down regulates the production and action of TNFa on TNF receptors 1 and 2, which has a crucial role in the production of blisters in PV [3,10,11].…”

Section: Discussionmentioning

confidence: 99%

“…In addition, both drugs directly inhibit antibody production by B cells [11]. Furthermore, the use of two anti-tumor necrosis factor (TNF) a drugs; sulphasalazine and pentoxifylline down regulates the production and action of TNFa on TNF receptors 1 and 2, which has a crucial role in the production of blisters in PV [3,10,11]. However, the significantly better results observed in the group (B) patients who received IFN in combination with our standard therapy is a further proof to the boosting effects of IFN addition to the standard PV treatment.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Study of T helper 1 and T helper 2 responses in pemphigus vulgaris patients receiving interferon alpha 2a injections in addition to a standard protocol therapy: a randomized controlled trial

et al. 2014

View full text Add to dashboard Cite

T helper (Th)1 insufficiency was recently found to be related to the pathogenesis of pemphigus vulgaris (PV). Decreased Th1 response was particularly noticed in the early stages of PV. Therefore, administration of interferon alpha in the early stages of aggressive PV may lead to rapid control of the acute stage of the disease. Our aim was to evaluate the role of interferon alpha in the treatment of PV. 30 patients with acute severe PV (>60 % affection) and 30 age and sex-matched healthy subjects were included in this RCT. Patients were randomly divided into two groups (A and B). Group B patients received interferon retard (one subcutaneous injection/week for 4 weeks) in addition to our protocol for the treatment of PV (systemic pulse corticosteroids/cyclophosphamide in combination with sulphasalazine and pentoxifylline) that was administered to all the included patients. IFN-γ and IL-4 were estimated by ELISA before treatment, after 4 weeks and at the end of the study duration (12 weeks). Clinical assessment was done by PAAS on a biweekly basis. All PV patients showed significantly (P < 0.001) elevated levels of IL-4 and significantly (P < 0.001) depressed mean concentration of IFN-γ as compared with healthy controls. Twelve weeks after therapy both groups showed significant improvement in their mean PAAS being more evident and more rapid in group B. IFN-γ was elevated significantly and IL-4 was dropped significantly in group B patients in comparison to group A (P < 0.001). As a conclusion, interferon therapy in severe PV could achieve a more prompt and better clinical response.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Study of T helper 1 and T helper 2 responses in pemphigus vulgaris patients receiving interferon alpha 2a injections in addition to a standard protocol therapy: a randomized controlled trial

et al. 2014

View full text Add to dashboard Cite

show abstract

“…To explore the benefit of corticosteroid-sparing regimens four more controlled prospective clinical studies have been performed applying cyclophosphamide, cyclosporine, dapsone, and sulfasalazine plus pentoxifylline [26][27][28][29]. Only the combination of sulfasalazine and pentoxifylline was shown to be advantageous compared to the control group whereas in patients of the cyclosporine group, significantly more adverse events were seen [27,29].…”

Section: Pemphigusmentioning

confidence: 99%

“…Only the combination of sulfasalazine and pentoxifylline was shown to be advantageous compared to the control group whereas in patients of the cyclosporine group, significantly more adverse events were seen [27,29]. Very recently, the retrospective analysis of 136 pemphigus patients adjuvantly treated with methotrexate in 7 studies revealed a clinical improvement in more than 80% of patients [30].…”

Section: Pemphigusmentioning

confidence: 99%

Current Treatment of Autoimmune Blistering Diseases

Kasperkiewicz

Schmidt

2009

CDDT

View full text Add to dashboard Cite

Autoimmune bullous diseases are a heterogeneous group of disorders that can be subdivided according to the level of split formation in the intraepidermal blistering pemphigus diseases and subepidermal bullous disorders, latter including pemphigoid diseases, epidermolysis bullosa acquisita, and dermatitis herpetiformis. In the majority of autoimmune bullous disorders, disease activity can be sufficiently controlled by systemic corticosteroids in combination with further immunosuppressants/immunomodulants such as dapsone, doxycycline, methotrexate, azathioprine, or mycophenolate mofetil. In contrast, in pemphigus, mucous membrane pemphigoid, and epidermolysis bullosa acquisita, treatment is challenging and only in a minority of patients, conventional immunosuppressive therapy induces clinical remission. Since only a few years ago, only cyclophosphamide and high-dose intravenous immunoglobulin were available as potent second-line therapies. Meanwhile, immunoadsorption and the monoclonal anti-CD20 antibody rituximab have been established as further therapeutic options. Here, both conventional therapies and novel treatment regimens for autoimmune blistering diseases are discussed.

show abstract

“…These uniform parameters will then permit meta-ana lyses to be performed to compare studies, even if the numbers are relatively low, and provide better evidence for the treatments being assessed. New approaches to treatment are developing, such as the use of sulfasalazine and pentoxifylline [74].…”

Section: Five-year Viewmentioning

confidence: 99%

Treatment of pemphigus vulgaris and pemphigus foliaceus

Sebaratnam

Murrell

2009

Expert Review of Dermatology

View full text Add to dashboard Cite

Pemphigus is a rare autoimmune bullous disease, and the best evidence-based approach to the management of this dermatosis is still a contentious issue. Therapeutic approaches must recognize the chronic, relapsing and remitting nature of the disease and that morbidity is mainly a result of treatment. Corticosteroids are the cornerstone of treatment; however, adjuvant therapies, such as azathioprine, mycophenolate mofetil, cyclophosphamide, and newer therapies, such as plasmapheresis, intravenous immunoglobulin and rituximab, are being increasingly utilized. At present, treatment regimes are ostensibly based on the clinical experience of the physician, rather than on empirical evidence, as research in the field of pemphigus is fraught with a number of intrinsic difficulties. This review aims to provide an evaluation of the different treatment options that are available and the evidence in the literature that advocates or opposes their use. Keywords: azathioprine • bullous disease • cyclophosphamide • mycophenolate mofetil • pemphigus • pemphigus foliaceus • pemphigus vulgaris • prednisone Treatment of pemphigus vulgaris and pemphigus foliaceus Expert Rev Dermatol. 4(5), 469-481 (2009) Learning objectives Upon completion of this activity, participants should be able to: • Describe the use of corticosteroids to treat pemphigus • Identify effective adjuvant treatments for pemphigus • Treat recalcitrant cases of pemphigus effectively • Describe emerging treatments for pemphigusFor reprint orders, please contact reprints@expert-reviews.com

show abstract

The use of sulfasalazine and pentoxifylline (low-cost antitumour necrosis factor drugs) as adjuvant therapy for the treatment of pemphigus vulgaris: a comparative study

Abstract: The use of PTX and SSZ as adjuvant therapy in the treatment of PV induced a faster and more significant decrease in the serum level of TNF-alpha, and this decrease was associated with rapid clinical improvement.

Cited by 40 publications

References 29 publications

Study of T helper 1 and T helper 2 responses in pemphigus vulgaris patients receiving interferon alpha 2a injections in addition to a standard protocol therapy: a randomized controlled trial

Study of T helper 1 and T helper 2 responses in pemphigus vulgaris patients receiving interferon alpha 2a injections in addition to a standard protocol therapy: a randomized controlled trial

Current Treatment of Autoimmune Blistering Diseases

Treatment of pemphigus vulgaris and pemphigus foliaceus

Contact Info

Product

Resources

About