Document Detail

Pulse versus oral methylprednisolone therapy in pemphigus vulgaris.
MedLine Citation:
PMID:  17198445     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Although corticosteroids have dramatically altered the prognosis of patients with pemphigus vulgaris, morbidity and mortality from systemic corticosteroid side-effects remains high. High-dose intravenous methylprednisolone has been used successfully in blistering diseases to avoid the complications of long-term orally-administered glucocorticoids. The objective of this study was to compare the effectiveness and side-effects of oral and pulse steroid therapy in the treatment of pemphigus vulgaris.
METHODS: One hundred and twenty-three patients with pemphigus vulgaris were categorized into two groups of study and control according to the disease severity and patient's preferred method of treatment. The study group included 36 males and 36 females. The control group included 26 males and 25 females. The mean +/- SD age of the two groups was 42.6 +/- 11.9 and 46.9 +/- 12.8 years, respectively. The mean +/- SD duration of the disease was 6.8 +/- 1.1 months in new cases (n = 45) and 25.9 +/- 26.0 months overally in the study group; it was 7.2 +/- 1.8 months in new cases (n = 30) and 28.4 +/- 24.6 months overally in the control group. During the induction phase, we performed pulse therapy with methylprednisolone in three consecutive monthly courses. Each course included 1000 mg intravenous methylprednisolone for 4 days plus 500 mg intravenous cyclophosphamide for 1 day. In this phase, the control group received 1 - 2 mg/kg/day oral prednisolone for 28 days plus 1.5 mg/kg/day azathioprine. All patients were followed for at least 12 months during which period, clinical response, relapse rate, and side-effects were evaluated.
RESULTS: Pulse intravenous methylprednisolone with cyclophosphamide was generally safe and well-tolerated. Therapeutic responses of skin and mucosal lesions, rates of complete remission and relapse, and major organ-specific complications were similar in both groups. Significant statistical differences existed in total orally-administered prednisolone in one year, admission duration, and annual weight increments between the two groups (P < 0.05).
CONCLUSION: Considering the side-effects of long-term oral steroids, hazards of obesity, and complications of long-term hospitalization, pulse methylprednisolone could be considered in patients who have problems with long-term admissions or with high-dose oral steroid usage, and also in obese patients.
Mohammad Shahidi-Dadras; Ahdieh Karami; Parviz Toosy; Ali Shafiyan
Related Documents :
9778225 - Intravenous pulse administration of cyclophosphamide versus daily oral treatment in pat...
9074565 - Guillain-barré syndrome. a severe case calling for intensive treatment.
8290795 - Salivary immunoglobulin a production in chronic bronchitis patients given an orally adm...
7596005 - Periodic treatment regimens with inhaled steroids in asthma or chronic obstructive pulm...
24888365 - A retrospective analysis of the clinical efficacies of q-switched alexandrite and q-swi...
25257235 - Unipedal balance is affected by lower extremity joint arthroplasty procedure 1 year fol...
Publication Detail:
Type:  Controlled Clinical Trial; Journal Article    
Journal Detail:
Title:  Archives of Iranian medicine     Volume:  10     ISSN:  1029-2977     ISO Abbreviation:  Arch Iran Med     Publication Date:  2007 Jan 
Date Detail:
Created Date:  2007-01-02     Completed Date:  2007-02-22     Revised Date:  2013-05-15    
Medline Journal Info:
Nlm Unique ID:  100889644     Medline TA:  Arch Iran Med     Country:  Iran    
Other Details:
Languages:  eng     Pagination:  1-6     Citation Subset:  IM    
Department of Dermatology, Shaheed Beheshti University of Medical Sciences, Loghman Hakim Hospital, Tehran, Iran.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Administration, Oral
Follow-Up Studies
Glucocorticoids / administration & dosage*,  therapeutic use
Injections, Intravenous
Methylprednisolone / administration & dosage*,  therapeutic use
Middle Aged
Pemphigus / drug therapy*,  pathology
Retrospective Studies
Time Factors
Treatment Outcome
Reg. No./Substance:
0/Glucocorticoids; 83-43-2/Methylprednisolone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Negative differential resistance and memory effect in diodes based on 1,4-dibenzyl C60 and zinc phth...
Next Document:  Clinical presentation and etiologic factors of hirsutism in premenopausal Iranian women.