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Related Experiment Videos

Dexamethasone-cyclophosphamide pulse therapy for pemphigus

J S Pasricha1, B K Khaitan, R S Raman

  • 1Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India.

International Journal of Dermatology
|December 1, 1995
PubMed
Summary

This study presents a novel dexamethasone and cyclophosphamide pulse (DCPS) therapy for pemphigus, achieving an 84% remission rate in 227 patients. The treatment shows potential for curing this severe autoimmune disease with minimal side effects.

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Area of Science:

  • Autoimmune diseases
  • Dermatology
  • Immunosuppressive therapy

Background:

  • Pemphigus is a severe, potentially fatal autoimmune blistering disease.
  • Traditional treatments often involve significant corticosteroid side effects.
  • A novel treatment approach has been developed over the last 12 years.

Purpose of the Study:

  • To evaluate the efficacy and safety of a novel pulsed dexamethasone and cyclophosphamide (DCPS) regimen for pemphigus.
  • To assess long-term remission rates and disease control.
  • To investigate the impact on intercellular antibody levels and treatment-related side effects.

Main Methods:

  • The DCPS regimen involves pulsed administration of dexamethasone and cyclophosphamide every 4 weeks.
  • Patients received daily oral cyclophosphamide between pulses and generally no corticosteroids.

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  • Treatment included a maintenance phase of 1.5 years post-remission.

    • Main Results:

    • Out of 300 enrolled patients, 190 (84%) achieved complete remission and were disease-free after treatment completion.
    • Long-term follow-up (up to 9 years) confirmed sustained remission in many patients.
    • Side effects were generally absent or insignificant compared to traditional corticosteroid therapy.
    • Intercellular antibody levels decreased during treatment.
    • Relapses were mostly observed in patients who defaulted, and DCPS re-treatment led to recovery.

    Conclusions:

    • The DCPS regimen demonstrates high efficacy and safety in treating pemphigus.
    • This pulsed therapy shows potential as a curative treatment for pemphigus.
    • Further long-term follow-up is warranted to fully substantiate its curative potential.