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Intermittent high-dose dexamethasone-cyclophosphamide therapy for pemphigus
J S Pasricha1, J Thanzama, U K Khan
1Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi.
The British Journal of Dermatology
|July 1, 1988
Summary
This study evaluated a novel intermittent high-dose (IHD) dexamethasone and cyclophosphamide regimen for pemphigus treatment. The regimen showed promise in managing pemphigus, with many patients achieving remission or discontinuing treatment.
Area of Science:
- Immunology
- Dermatology
- Pharmacology
Background:
- Pemphigus is a rare autoimmune blistering disease.
- Current treatments can have significant side effects.
- A need exists for effective and tolerable pemphigus therapies.
Purpose of the Study:
- To assess the efficacy and safety of an intermittent high-dose (IHD) dexamethasone and cyclophosphamide regimen for pemphigus vulgaris.
- To evaluate the treatment outcomes across four distinct phases.
Main Methods:
- Retrospective analysis of 79 pemphigus patients treated since 1982.
- Treatment involved IHD dexamethasone (100 mg IV) and cyclophosphamide (500 mg IV on day 1), followed by daily oral cyclophosphamide (50 mg).
- Treatment was divided into four phases: active disease management, IHD continuation, oral cyclophosphamide maintenance, and observation.
Main Results:
- Of 67 evaluable patients, 25 achieved complete remission and were off treatment (Phase IV).
- 25 patients were on oral cyclophosphamide maintenance (Phase III).
- 10 patients were in remission but still on IHD therapy (Phase II), and 7 had active disease (Phase I).
Conclusions:
- The IHD dexamethasone and cyclophosphamide regimen demonstrates potential for pemphigus treatment.
- The phased approach allows for progressive reduction in therapy intensity.
- Further research is warranted to optimize this treatment strategy.