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Pulse intravenous cyclophosphamide therapy in pemphigus
M E Fleischli1, R H Valek, A G Pandya
1Department of Dermatology, University of Texas Southwestern Medical Center, Dallas 75235-9069, USA.
Archives of Dermatology
|January 29, 1999
Summary
Intravenous pulse cyclophosphamide shows promise for treating severe pemphigus. This therapy helped most patients reduce corticosteroid use and experienced minimal side effects, offering a potential alternative to oral immunosuppressives.
Area of Science:
- Dermatology
- Immunology
- Pharmacology
Background:
- Pemphigus treatment often involves corticosteroids, which carry significant risks.
- Adjuvant therapies are used to improve disease control and reduce corticosteroid toxicity.
- Oral immunosuppressives, while effective, are associated with an increased risk of malignancy.
Purpose of the Study:
- To evaluate the efficacy and safety of intravenous pulse cyclophosphamide in patients with severe or recalcitrant pemphigus.
- To assess the potential of this therapy to reduce corticosteroid dependence and adverse effects.
Main Methods:
- Retrospective review of 9 patients with pemphigus.
- Treatment with intravenous pulse cyclophosphamide therapy.
- Monitoring of patient response, including skin lesion status and corticosteroid dosage.
Main Results:
- Six out of 9 patients responded to intravenous pulse cyclophosphamide therapy.
- Two patients achieved complete remission of skin lesions.
- Five patients reduced their prednisone dosage, and one discontinued it entirely.
- Most patients experienced minimal or no adverse effects.
Conclusions:
- Intravenous pulse cyclophosphamide is a potential alternative for pemphigus patients resistant to standard treatments.
- Monthly pulse dosing may lower the risk of secondary malignancies compared to continuous oral cyclophosphamide.
- Further controlled trials are necessary to confirm the efficacy of this therapeutic approach.