Corticosteroid/cyclophosphamide pulse treatment in South African patients with pemphigus

Shaik, F; Botha, Julia; Aboobaker, Jamila; Mosam, Anisa

doi:10.1111/j.1365-2230.2009.03450.x

Cited by 10 publications

(12 citation statements)

References 19 publications

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“…Many other retrospective case series describing the encouraging results of this treatment approach have been published both from Indian centres and from other countries around the world including Iran, South Africa, the U.K. and Serbia . In one study, 100% of 32 patients with PV completed the regimen and were off treatment, in remission …”

Section: Adjuvant Drugsmentioning

confidence: 99%

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British Association of Dermatologists’ guidelines for the management of pemphigus vulgaris 2017

et al. 2017

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Section: Adjuvant Drugsmentioning

confidence: 99%

“…Advocates of the DCP regimen claim relative freedom from corticosteroid side‐effects, but 20–85% of menstruating women developed amenorrhoea; azoospermia in men was also noted. Haemorrhagic cystitis occurred in 0·6% and pituitary–adrenal suppression in 55% (17 of 31) of patients …”

Section: Adjuvant Drugsmentioning

confidence: 99%

British Association of Dermatologists’ guidelines for the management of pemphigus vulgaris 2017

et al. 2017

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“…[5,[54][55][56][57][58][59][60][61][62][63] Although Western Dermatology community has remained skeptical about the safety of the regimen, three recent reports from UK, South Africa, and Serbia have found its usefulness. [64][65][66] Ramam, in his editorial in this very journal, has outlined the way forward for DCP. [67] These include the need to identify the difficult situations in pulse therapy and to evolve ways including required modification in the pulse therapy to circumvent these difficulties, addition of another adjuvant to DCP for those who are not responding to DCP even after reasonable period, to identify patient in the very early stages who would respond early to treatment so as to spare them from unnecessary pulses, omission of daily cyclophosphamide for the first two phase when dexamethasone and cyclophosphamide boluses are being given while giving it in phase 3, pharmacokinetic and immunologic studies on DCP, etc., to improve the understanding of this regimen.…”

Section: Diagnosismentioning

confidence: 99%

Pemphigus in India

Kanwar¹,

De²

2011

Indian J Dermatol Venereol Leprol

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Pemphigus is a chronic epidermal immunobullous disease with potentially fatal outcome. The journey of literature on pemphigus in India has come a long way in last five decades. Pemphigus in Indian patients has unique genetic, clinical, and epidemiological differences from those in the Western countries. Corticosteroids remain the mainstay of treatment for pemphigus. Dexamethasone-cyclophosphamide pulse therapy has revolutionized the management of pemphigus in India and abroad for nearly 3 decades now. Corticosteroid-based treatment, along with adjuvants, has significantly brought down the high mortality rates that had been observed in precorticosteroid era. Present day research is largely based on elucidating the pathogenesis beyond the antidesmoglein antibodies, and newer diagnostic and treatment approaches. In this article, we review various aspects of literature on pemphigus in India, on Indians abroad, or literature from other countries that are considered relevant to the topic.

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“…Paradoxically, although there is no validated severity index in pemphigus, the clinical severity of the disease is taken into account for increasing the intensity of the treatment in clinical therapeutic trials in pemphigus. In the study of Shaih, 73% of patients who presented with severe disease did receive additional oral corticosteroids between treatment pulses of corticosteroids and cyclophosphamide [8]. But severity was not objectively determined.…”

Section: Discussionmentioning

confidence: 99%

Pemphigus: use of the Japanese severity index in 56 Moroccan patients

Benchikhi¹,

Nani²,

Baybay³

et al. 2013

Pan Afr Med J

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IntroductionIn pemphigus, there still is no consensus on parameters mesuring clinically the disease severity. The aim of this study is to use the Japanese severity index in Moroccan patients with pemphigus.MethodsMulticenter prospective study from September 2007 to September 2009 including consecutive patients with confirmed pemphigus. We used the Japenese severity index for pemphigus. For each patient, the score was calculated at diagnosis and at 6 months of follow-up and correlated to type of pemphigus; mean dosage of corticosteroids and clinical statuts at 6 months: dead or not.ResultsFifty six patients were included, 20 men and 36 women, mean age 46.62 ± 15.9 years. At diagnosis, the mean initial score was 7.7 + 2.36; at six months, it was 1.61 + 1.83. The score variation at 6 months and inclusion was 6.19 ± 2.18 for deep pemphigus and 5.43 ± 2.85 for superficial pemphigus (p = 0,3 non significant). At six months, 4 patients were dead: their initial score was 11 + 1.41 while the initial score in the 52 patients was 7.4±2.03 (p = 0,001, significant). Data showed no correlation between initial severity scores and cumulative dosage of corticosteroids at 6 months (Pearson coefficient of correlation 0.144; p = 0.580).ConclusionIn this study, initial severity scores for pemphigus were high and decreased at 6 months of treatment. Both deep pemphigus and superficial pemphigus were severe as their score variation was similar. Japenese severity score is useful for Moroccan patients with pemphigus.

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Corticosteroid/cyclophosphamide pulse treatment in South African patients with pemphigus

Cited by 10 publications

References 19 publications

British Association of Dermatologists’ guidelines for the management of pemphigus vulgaris 2017

British Association of Dermatologists’ guidelines for the management of pemphigus vulgaris 2017

Pemphigus in India

Pemphigus: use of the Japanese severity index in 56 Moroccan patients

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