[Open trial of mycophenolate mofetil in the treatment of resistant pemphigus vulgaris].
BACKGROUND
Pemphigus vulgaris is a severe autoimmune blistering disease of the skin and mucous membranes. In absence of treatment, mortality is high. In the past, prednisolone was the best treatment. Later, combination therapy with systemic prednisolone and other disease-modifying drugs was tried with better results. Unfortunately, some patients do not respond well to such treatment, or may exhibit multiple recurrences or complications. Some other patients may remain on high dose corticosteroids to maintain remission.


OBJECTIVE
To evaluate the efficacy and safety of mycophenolate mofetil as a steroid sparing agent in the treatment of resistant pemphigus vulgaris.


METHODS
We administered 2 g daily mycophenolate mofetil with systemic steroids to 10 patients with resistant and severe disease who did not respond to conventional therapy, or had multiple recurrences.


RESULTS
Nine of the ten patients responded to treatment and showed complete clearance of lesions within 6 to 16 weeks of therapy. At the end of six months, the dose of prednisolone was significantly lower. Side effects were few and mild. After discontinuation of mycophenolate mofetil, 5 of the 9 patients relapsed.


CONCLUSIONS
Mycophenolate mofetil is effective and safe as a disease-modifying drug combined with prednisolone in the treatment of patients with resistant pemphigus vulgaris. To induce long lasting remission has to be administrated for more than 6 months.
Chams-Davatchi
C
C
Centre de Dermatologie de l'Université de Téhéran, hôpital Razi, Téhéran, Iran. chamsc@yahoo.com
Nonahal Azar
R
R
Daneshpazooh
M
M
Valikhani
M
M
Hallaji
Z
Z
Barzegari
M
M
Firouz
A-R
AR
Zakeri
M
M
D000293:Adolescent; D000328:Adult; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004341:Drug Evaluation; D004351:Drug Resistance; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000008:administration & dosage* / Q000009:adverse effects / Q000031:analogs & derivatives*; D010392:Pemphigus / Q000175:diagnosis / Q000188:drug therapy*; D011239:Prednisolone / Q000008:administration & dosage / Q000009:adverse effects
D007166:Immunosuppressive Agents; D011239:Prednisolone; D009173:Mycophenolic Acid
Etude ouverte du mycophénolate mofetil dans le traitement du pemphigus résistant.