Treatment of pemphigus vulgaris and pemphigus foliaceus with mycophenolate mofetil.
BACKGROUND
Mycophenolate mofetil is increasingly being used as a corticosteroid-sparing agent in immunosuppressive regimens.


OBJECTIVE
To elucidate the effectiveness of mycophenolate as adjuvant therapy in the treatment of both pemphigus vulgaris and pemphigus foliaceus.


METHODS
Historical prospective study.


METHODS
University hospital.


METHODS
The study included 42 consecutive patients with pemphigus (31 with pemphigus vulgaris and 11 with pemphigus foliaceus) who had relapses during prednisone taper or had clinically significant adverse effects from previous drug therapy.


RESULTS
Remission was achieved in 22 (71%) and 5 (45%) of patients with pemphigus vulgaris and pemphigus foliaceus, respectively. Partial remission was achieved in 1 (3%) and 4 (36%), respectively. The median time to achieve complete remission was 9 months (range, 1-13 months). The treatment was administered for a median of 22 months, and the median follow-up period was 22 months. Seventy-seven percent of patients had no adverse effect. Two patients had side effects severe enough to necessitate discontinuation of treatment, one because of symptomatic but reversible neutropenia and the other because of nausea.


CONCLUSIONS
Mycophenolate is an effective and safe adjuvant in the treatment of both pemphigus vulgaris and pemphigus foliaceus.
Mimouni
Daniel
D
Department of Dermatology, Johns Hopkins University, School of Medicine, Baltimore, MD 21205, USA.
Anhalt
Grant J
GJ
Cummins
Deborah L
DL
Kouba
David J
DJ
Thorne
Jennifer E
JE
Nousari
H Carlos
HC
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003879:Dermatologic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use*; D010392:Pemphigus / Q000188:drug therapy*; D011446:Prospective Studies; D012074:Remission Induction; D012720:Severity of Illness Index; D013997:Time Factors
D003879:Dermatologic Agents; D009173:Mycophenolic Acid