Yearly reduction of glucocorticoid dose by 50% as tapering schedule achieves complete remission for 124 pemphigus vulgaris patients.
Glucocorticoids are the first-line treatment for pemphigus vulgaris. Among 140 patients receiving systemic glucocorticoids, 124 patients achieved complete remission off or on a prednisone dose of ≤10 mg/day or less for 6 months or more. The mean average steroid controlling doses were 0.65, 0.62, 0.80, 1.08 and 1.38 mg/kg per day for the mucosal-dominant patients and the mild, moderate, severe and extensive cutaneous-involved patients, respectively (P < 0.001). The mean durations of the initial tapering after controlling doses started were 77.98, 48.78, 31.74 and 28.83 days when the disease was controlled with doses of 40 mg/day or less, 45-60 mg/day, 65-80 mg/day and more than 80 mg/day for the cutaneous-involved types, respectively (P < 0.005). Of the patients, 79.51% achieved complete remission within 3 years, 98.36% within 5 years and all within 6 years, which corresponded to a 50% yearly reduction of glucocorticoid dose. These successfully treated patients indicate that a severity-tailored initial dose of glucocorticoids, an initial tapering duration based on the initial dose and a subsequent 50% yearly tapering regimen may cure pemphigus vulgaris within 3-6 years.
Department of Dermatology, Peking University First Hospital, Beijing, China.|Beijing Key Laboratory of Molecular Diagnosis of Dermatoses, Beijing, China.
Mingyue
M
Wang
Department of Dermatology, Peking University First Hospital, Beijing, China.|Department of Dermatology, Binzhou Medical University Hospital, Binzhou, China.
Yu
Y
Gao
Department of Dermatology, Peking University First Hospital, Beijing, China.|Beijing Key Laboratory of Molecular Diagnosis of Dermatoses, Beijing, China.
Yang
Y
Peng
Department of Dermatology, Peking University First Hospital, Beijing, China.|Beijing Key Laboratory of Molecular Diagnosis of Dermatoses, Beijing, China.
Junyu
J
Zhao
Department of Dermatology, Peking University First Hospital, Beijing, China.|Beijing Key Laboratory of Molecular Diagnosis of Dermatoses, Beijing, China.
Xixue
X
Chen
Department of Dermatology, Peking University First Hospital, Beijing, China.|Beijing Key Laboratory of Molecular Diagnosis of Dermatoses, Beijing, China.
Xuejun
X
Zhu
D000328:Adult; D000368:Aged; D004334:Drug Administration Schedule; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010392:Pemphigus / Q000188:drug therapy*; D011241:Prednisone / Q000008:administration & dosage; D020551:Pulse Therapy, Drug; D012074:Remission Induction; D012189:Retrospective Studies; D055815:Young Adult
D005938:Glucocorticoids; D011241:Prednisone
Chinese; glucocorticoids; pemphigus vulgaris; remission; therapeutics