title: Mycophenolate mofetil and enteric-coated mycophenolate sodium in the treatment of pemphigus vulgaris and pemphigus foliaceus.
abstract: What is known and objective: Pemphigus is a severe, potentially life-threatening autoimmune blistering disease. The use of corticosteroids has dramatically improved the prognosis and changed its course. However, current morbidity of pemphigus is largely iatrogenic, caused by side effects of the long-term, high-dose corticosteroid therapy that is necessary to sustain disease control. In order to minimize side effects, a range of corticosteroid-sparing immunosuppressive agents have been introduced, including mycophenolate mofetil (MMF) and enteric-coated mycophenolate sodium (EC-MPS). A systematic review was performed to evaluate the effectiveness of MMF and EC-MPS in the treatment of pemphigus vulgaris and pemphigus foliaceus.
  
  
  METHODS
  A retrospective literature search was conducted through multiple electronic databases (PubMed, Medline, The Cochrane database of systematic reviews) for reports on the use of mycophenolic acid (MPA) in the treatment of pemphigus vulgaris and pemphigus foliaceus.
  
  
  RESULTS
  Sixteen studies with a total of 239 patients have evaluated the treatment of pemphigus vulgaris and pemphigus foliac;eus with MPA. The majority of patients had refractory disease treated with corticosteroids as monotherapy or associated to adjuvant agents.
  
  
  CONCLUSIONS
  The results of this review suggest that MPA, as MMF or EC-MPS, may be a promising adjuvant or alternative therapy for the treatment of pemphigus vulgaris and pemphigus foliaceus. It appears safe, at least in the medium term and its adverse events seem to be dose dependent.
  
  
  CONCLUSIONS
  The use of mycophenolate is first-line adjuvant therapy in the treatment of pemphigus vulgaris and pemphigus foliaceus.
authors: Department of Dermatology, University of Palermo , Palermo, Sicily , Italy.
authors: Spyridoula
authors: S
authors: Doukaki
authors: Andrea
authors: A
authors: Platamone
authors: Roberta
authors: R
authors: Alaimo
authors: Maria Rita
authors: MR
authors: Bongiorno
mesh_terms: D003879:Dermatologic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D009173:Mycophenolic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D010392:Pemphigus / Q000188:drug therapy* / Q000473:pathology; D011379:Prognosis; D016896:Treatment Outcome
chemical_list: D003879:Dermatologic Agents; D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid
keywords: Enteric-coated mycophenolate sodium; mycophenolate mofetil; mycophenolic acid; pemphigus foliaceus; pemphigus vulgaris; therapy