Successful treatment of mucous membrane pemphigoid with etanercept in 3 patients.
BACKGROUND
Mucous membrane pemphigoid (MMP), also known as cicatricial pemphigoid, is a serious, autoimmune, blistering disorder that can result in blindness and other complications as a result of scarring of the mucous membranes. Effective treatment modalities are often toxic. Herein, we describe a novel therapeutic approach that is based on 2 reports in the literature of the successful use of etanercept to treat MMP.


METHODS
Three patients with MMP were treated with subcutaneous injections of 25 mg of etanercept twice weekly. All 3 patients had oral mucosal involvement, and 1 had severe, recalcitrant, ocular disease. Oral mucosal disease improved in all 3 patients. The patient with ocular involvement experienced stabilization of progression.


CONCLUSIONS
Effective treatment modalities for MMP are often toxic. Etanercept may be an effective treatment option for MMP of the oral and ocular mucous membranes. This therapy should be considered as an alternative treatment option for patients who would require other aggressive systemic treatments, such as cyclophosphamide, corticosteroids, azathioprine sodium, and intravenous immunoglobulin.
Canizares
Maria J
MJ
Division of Dermatology, Department of Ophthalmology, Washington University School of Medicine, St Louis, MO, USA.
Smith
David I
DI
Conners
Michael S
MS
Maverick
Kenneth J
KJ
Heffernan
Michael P
MP
D003229:Conjunctival Diseases / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology; D003937:Diagnosis, Differential; D000068800:Etanercept; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000008:administration & dosage / Q000627:therapeutic use*; D007155:Immunologic Factors / Q000008:administration & dosage / Q000627:therapeutic use*; D007279:Injections, Subcutaneous; D008875:Middle Aged; D010390:Pemphigoid, Benign Mucous Membrane / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D018124:Receptors, Tumor Necrosis Factor / Q000008:administration & dosage / Q000627:therapeutic use*; D012720:Severity of Illness Index; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
D007074:Immunoglobulin G; D007155:Immunologic Factors; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D000068800:Etanercept