Dexamethasone-cyclophosphamide pulse therapy in pemphigus: a review of 72 cases.
BACKGROUND
Autoimmune pemphigus is a group of severe blistering diseases. Although corticosteroids have dramatically altered the prognosis of pemphigus, morbidity and mortality resulting from the adverse effects of systemic corticosteroids remain high. Dexamethasone-cyclophosphamide pulse (DCP) therapy was introduced to diminish the adverse effects of prolonged conventional daily dose regimens.


OBJECTIVE
To report our experience with the use of the DCP regimen in patients with autoimmune pemphigus.


METHODS
In the period 1998-2002, 72 patients with various forms of autoimmune pemphigus treated with DCP therapy were included, of whom 36 patients were previously treated with conventional corticosteroid therapy, and 36 were newly diagnosed patients.


RESULTS
Of the 72 patients, 43 completed treatment, while 13 patients did not respond adequately to the treatment and continued with the conventional daily regimen, nine patients were lost to follow-up, and seven patients died. Two of these deaths were probably a consequence of DCP therapy.


CONCLUSIONS
DCP regimen is a beneficial treatment for patients with pemphigus, sparing the adverse effects of conventional regimens.
Institute of Dermatovenereology, Clinical Center of Serbia, Belgrade, Serbia.
Dubravka
D
Zivanovic
Ljiljana
L
Medenica
Srdjan
S
Tanasilovic
Sonja
S
Vesic
Dusan
D
Skiljevic
Maja
M
Tomovic
Milos M
MM
Nikolic
D000328:Adult; D000368:Aged; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D003907:Dexamethasone / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010392:Pemphigus / Q000188:drug therapy* / Q000503:physiopathology; D020551:Pulse Therapy, Drug / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult
D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D003907:Dexamethasone; D003520:Cyclophosphamide