TY - JOUR
T1 - The efficacy of combined treatment with prednisone and cyclosporine in patients with pemphigus
T2 - Preliminary study
AU - Lapidoth, Moshe
AU - David, Michael
AU - Ben-Amitai, Dan
AU - Katzenelson, Varda
AU - Lustig, Shamir
AU - Sandbank, Miriam
PY - 1994
Y1 - 1994
N2 - Background: Cyclosporine, a potent immunosuppressive drug, has been suggested to be beneficial in the treatment of some immune-mediated dermatoses, including pemphigus. Objective: The aim of the present study was to evaluate the efficacy and safety of combined treatment with prednisone and cyclosporine compared with prednisone alone in patients with pemphigus. Methods: Sixteen hospitalized patients with pemphigus vulgaris received combined treatment with cyclosporine and prednisone for 12 months. Cyclosporine and prednisone were given orally at an initial dose of 5 mg/kg/day and 60 to 80 mg/day, respectively. The cyclosporine dose was adjusted to obtain plasma levels of 100 to 150 ng/L. A historical control group was composed of 15 patients with pemphigus who received prednisone at an initial dose of 120 mg/day, which was decreased according to clinical response. The clinical response, serum titer of autoantibodies, and frequency of side effects during a 1-year follow-up period were evaluated and compared. Results: The 16 patients in the combined therapy group achieved clinical remission within 25 days or less, a shorter period than for the control group, although the difference was not statistically significant. New blister formation ceased after a mean of 11.1 ± 7.9 days of onset of treatment in the combined treatment group versus 20.5 ± 12 days in the control group (p = 0.004). Hospital stay was shorter in the combined treatment group (mean, 32.6 ± 12.5 days) than in the control group (mean, 50.7 ± 17.1 days; p = 0.003). The mean total cumulative prednisone dosage during hospitalization and follow-up was 8853 ± 1915 mg in the combined treatment group versus 12,977 ± 2093 mg in the control group (p = 0.008). Conclusion: The combined use of prednisone and cyclosporine proved to be more effective than prednisone alone in the treatment of pemphigus vulgaris, and the cyclosporine was found to have a corticosteroid-sparing effect.
AB - Background: Cyclosporine, a potent immunosuppressive drug, has been suggested to be beneficial in the treatment of some immune-mediated dermatoses, including pemphigus. Objective: The aim of the present study was to evaluate the efficacy and safety of combined treatment with prednisone and cyclosporine compared with prednisone alone in patients with pemphigus. Methods: Sixteen hospitalized patients with pemphigus vulgaris received combined treatment with cyclosporine and prednisone for 12 months. Cyclosporine and prednisone were given orally at an initial dose of 5 mg/kg/day and 60 to 80 mg/day, respectively. The cyclosporine dose was adjusted to obtain plasma levels of 100 to 150 ng/L. A historical control group was composed of 15 patients with pemphigus who received prednisone at an initial dose of 120 mg/day, which was decreased according to clinical response. The clinical response, serum titer of autoantibodies, and frequency of side effects during a 1-year follow-up period were evaluated and compared. Results: The 16 patients in the combined therapy group achieved clinical remission within 25 days or less, a shorter period than for the control group, although the difference was not statistically significant. New blister formation ceased after a mean of 11.1 ± 7.9 days of onset of treatment in the combined treatment group versus 20.5 ± 12 days in the control group (p = 0.004). Hospital stay was shorter in the combined treatment group (mean, 32.6 ± 12.5 days) than in the control group (mean, 50.7 ± 17.1 days; p = 0.003). The mean total cumulative prednisone dosage during hospitalization and follow-up was 8853 ± 1915 mg in the combined treatment group versus 12,977 ± 2093 mg in the control group (p = 0.008). Conclusion: The combined use of prednisone and cyclosporine proved to be more effective than prednisone alone in the treatment of pemphigus vulgaris, and the cyclosporine was found to have a corticosteroid-sparing effect.
UR - http://www.scopus.com/inward/record.url?scp=0028304758&partnerID=8YFLogxK
U2 - 10.1016/S0190-9622(08)81506-X
DO - 10.1016/S0190-9622(08)81506-X
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AN - SCOPUS:0028304758
SN - 0190-9622
VL - 30
SP - 752
EP - 757
JO - Journal of the American Academy of Dermatology
JF - Journal of the American Academy of Dermatology
IS - 5
ER -