Document Detail


Assessment of the rate of long-term complete remission off therapy in patients with pemphigus treated with different regimens including medium- and high-dose corticosteroids.
MedLine Citation:
PMID:  23850258     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Few studies have evaluated pemphigus treatments according to the definitions of the consensus statement. Prognostic factors for complete remission off therapy (CRoffT) remain unknown.
OBJECTIVE: We sought to assess the rate of CRoffT in patients with pemphigus treated with different regimens.
METHODS: In all, 134 patients with pemphigus were included in a retrospective, multicenter study. Primary end point was the rate of CRoffT. Prognostic factors for CRoffT were determined using univariate and multivariate analyses.
RESULTS: Eighty patients with pemphigus vulgaris, 47 with pemphigus foliaceus, and 7 with paraneoplastic pemphigus were included. Mean age was 60 ± 18 years. Patients were treated either with medium (≤0.5 mg/kg/d) (n = 32) or high (≥1 mg/kg/d) (n = 59) doses of prednisone, or without systemic corticosteroids (n = 43). Mean follow-up was 77 ± 64 months. In all, 68 patients (50.7%) achieved CRoffT (95% confidence interval 42.3%-59.2%) after a mean treatment duration of 36 ± 39 months, including 47 of 80 patients with pemphigus vulgaris (58.7%) and 21 of 47 with pemphigus foliaceus (44.7%). Main prognostic factors for CRoffT were initial mucosal involvement (hazard ratio 2.2; 95% confidence interval 1.05-4.58; P = .036) and younger age (<61 years) (hazard ratio 2.5; 95% confidence interval 1.18-5.12; P = .0167). The rate of long-lasting CRoffT was 44%, with a mean follow-up after treatment withdrawal of 59 ± 50 months.
LIMITATIONS: This was a retrospective study.
CONCLUSION: The rate of CRoffT was 51%. Patients with pemphigus vulgaris were more likely to achieve CRoffT than those with pemphigus foliaceus.
Authors:
Naif Almugairen; Valerie Hospital; Christophe Bedane; Sophie Duvert-Lehembre; Damien Picard; Anne-Fleur Tronquoy; Estelle Houivet; Michel D'incan; Pascal Joly
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-7-12
Journal Detail:
Title:  Journal of the American Academy of Dermatology     Volume:  -     ISSN:  1097-6787     ISO Abbreviation:  J. Am. Acad. Dermatol.     Publication Date:  2013 Jul 
Date Detail:
Created Date:  2013-7-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7907132     Medline TA:  J Am Acad Dermatol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.
Affiliation:
Department of Dermatology, INSERM U 905, Institute for Research and Innovation in Biomedicine, Rouen University Hospital, University of Rouen, Rouen, France.
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