Gold: an old drug still working in refractory pemphigus.
BACKGROUND
The mainstay of treatment for pemphigus is systemic corticosteroids. Different adjuvants have been used to reduce side-effects of long-term corticotherapy. Gold is an anti-inflammatory drug used in autoimmune diseases, whose use has waned with the advent of new immunosuppressive agents.


OBJECTIVE
To study the outcome of the use of intramuscular gold treatment of pemphigus vulgaris refractory to previous therapies.


METHODS
Thirteen patients with pemphigus vulgaris who had failed to respond to several prior therapies were treated with aurothiomalate, as a steroid-sparing agent. Patients were monitored to assess disease activity and gold toxicity.


RESULTS
Seven patients achieved complete remission. Four patients were able to taper prednisone doses, although pemphigus flared when prednisone was discontinued or reduced. Toxicity was observed in the other two patients.


CONCLUSIONS
In 53.4% of the patients, the use of chrysotherapy resulted in the complete clearing of the disease, discontinuation of all systemic therapies and induced a long-term clinical remission. Prednisone doses were able to be reduced in the remaining 46.6%. Any side-effects were reversible with drug discontinuation. Gold therapy showed efficacy as a secondary line treatment in refractory pemphigus vulgaris.
Department of Dermatology, Hospital Clínic, Barcelona 08036, Spain. piranzo@clinic.ub.es
P
P
Iranzo
M M
MM
Alsina
I
I
Martínez-De Pablo
S
S
Segura
J M
JM
Mascaró
C
C
Herrero
D000328:Adult; D000368:Aged; D005260:Female; D006046:Gold / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D008875:Middle Aged; D010392:Pemphigus / Q000188:drug therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome
D006046:Gold