Recommandations des centres de référence des maladies bulleuses auto-immunes pour le diagnostic et la prise en charge de la pemphigoïde bulleuse

Bernard, Philippe; Bédane, C.; Prost, Cathérine; Ingen‐Housz‐Oro, Saskia; Joly, P.

doi:10.1016/j.annder.2011.01.009

Cited by 36 publications

(11 citation statements)

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“…Following French national recommendations for the diagnosis of BP [2], immunological tests are recommended but often not necessary for the diagnosis of typical situations. In contrast, BP180 and BP230 ELISA were reported as useful for the diagnosis of atypical BP, especially BP with atypical cutaneous presentation [14] or BP with mucosal lesions that are difficult to distinguish from mucous membrane pemphigoid [11].…”

Section: Commentmentioning

confidence: 99%

“…First-intent treatment is high-dose superpotent topical steroids for 6–12 months. Immunosuppressant agents such as methotrexate or mycophenolate mofetil are used in case of failure or dependence [2]. The autoantibodies mostly target two major components of the DEJ: BP230, also called BPAg1, an intracellular protein of the hemidesmosomal plaque, and BP180, or BPAg2, a transmembrane protein whose dominant epitope is located in the NC16A domain [3].…”

Section: Introductionmentioning

confidence: 99%

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The Value of BP230 Enzyme-Linked Immunosorbent Assay in the Diagnosis and Immunological Follow-Up of Bullous Pemphigoid

Peufeilhoux¹,

Ingen‐Housz‐Oro²,

Hüe³

et al. 2012

Dermatology

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Background: The value of 230-kDa bullous pemphigoid antibody (BP230) enzyme-linked immunosorbent assay (ELISA) for the diagnosis of bullous pemphigoid (BP) was investigated, but in the immunological follow-up of the disease remains unknown. Objective: Evaluation of BP230 ELISA for diagnosis, follow-up and prediction of relapse in BP. Methods: Monocenter retrospective and prospective study. Patients with typical BP. Detection of autoantibodies by indirect immunofluorescence (IIF), BP180 and BP230 ELISA tests at diagnosis, during the treatment (disease control or failure) and at treatment stop (relapse or not 3 months after). Results: 74 patients were included. At diagnosis, BP230 ELISA sensitivity was lower than IIF and BP180 ELISA. Combining both ELISA added a weak gain of sensitivity. Both tests paralleled the clinical evolution, especially in case of disease control. At the end of the treatment, BP230 ELISA was not different in patients with or without relapse. Conclusion: In routine practice, BP230 ELISA does not seem to be a useful additional test in typical BP.

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Section: Commentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Value of BP230 Enzyme-Linked Immunosorbent Assay in the Diagnosis and Immunological Follow-Up of Bullous Pemphigoid

Peufeilhoux¹,

Ingen‐Housz‐Oro²,

Hüe³

et al. 2012

Dermatology

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“…Scientific knowledge in the field of clinical research of bullous pemphigoid (BP), the most common autoimmune bullous disease, has significantly increased during the past years [1,2,3,4,5,6,7,8,9,10]. But until recently, the assessment of clinical activity in autoimmune bullous diseases was somewhat empirical and no activity score was systematically used.…”

Section: Introductionmentioning

confidence: 99%

Assessment of Bullous Pemphigoid Disease Area Index during Treatment: A Prospective Study of 30 Patients

et al. 2014

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Background: Recently, a consensus Bullous Pemphigoid Disease Area Index (BPDAI) was proposed to measure therapeutic outcomes in bullous pemphigoid (BP). Objective: To compare BPDAI with other clinical parameters of disease activity at baseline and to describe the variations of BPDAI during the initial phase of treatment. Methods: Thirty BP patients were included and followed for 1 year. BPDAI was assessed at baseline and on days 30, 90 and 360 by the same investigator. Concomitantly, the number of daily new blisters, the skin surface area of erythematous/eczematous/urticarial plaques and blisters/erosions, total lesion area (TLA), pruritus score and mucosal involvement were recorded. Results: At baseline, BPDAI was 46.7 ± 25 (mean ± SD); it was well correlated with erythematous/eczematous/urticarial skin surface (r = 0.63), TLA (r = 0.83), number of daily new blisters (r = 0.7; p ≤ 0.0002) and anti-BP180 autoantibodies (r = 0.49; p = 0.006), but not with anti-BP230 autoantibodies. For the 8 patients with severe BP at baseline, the mean BPDAI was 76.5, versus 35.9 for moderate BP (p = 0.0007). A value of 56 was proposed as a cut-off value for severe BP. BPDAI decreased to 11.9 ± 8.7, 10.7 ± 12.7 and 2.5 ± 4.1 on days 30, 90 and 360, respectively. Conclusion: BPDAI rapidly decreased during the early treatment stage of BP with variations almost totally conditioned by the skin activity component.

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“…First-line treatment was high-dose TCS (clobetasol propionate) in all cases but one (first treatment with oral prednisone), according to the French recommendations for the management of BP [21]. During treatment, 47 patients (48.5%) also received immunosuppressive agents, mostly methotrexate (39 cases).…”

Section: Resultsmentioning

confidence: 99%

“…Methotrexate was found to be effective as first-line treatment with short-term TCS in a retrospective study [5], and a prospective trial is being conducted in France. Methotrexate is also effective as a steroid-sparing agent in BP and is now recommended in France as second-line therapy after excluding contraindications, in contrast with other countries, where azathioprine is the drug of choice [4,5,21,22,23,24]. …”

Section: Discussionmentioning

confidence: 99%

Positive Direct Immunofluorescence Is of Better Value than ELISA-BP180 and ELISA-BP230 Values for the Prediction of Relapse after Treatment Cessation in Bullous Pemphigoid: A Retrospective Study of 97 Patients

Ingen‐Housz‐Oro

Plée

Belmondo³

et al. 2015

Dermatology

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Background: ELISA-BP180 values and direct immunofluorescence (DIF) are prognostic factors for relapse after treatment cessation in bullous pemphigoid (BP). Objective: To determine the relevance of ELISA-BP230 antibodies for predicting relapse 6 months after treatment cessation. Methods: We retrospectively selected patients with BP and available data from ELISA-BP180 and -BP230 and DIF performed at treatment cessation. The rate of relapse was calculated at 6 months. We compared ELISA-BP180 and -BP230 values and DIF in patients with relapse and remission. Results: We included 97 patients. At 6 months, 25.6% of patients showed relapse. The proportion of patients with an ELISA-BP230 value ≥27 UA/ml was higher, but not significantly, for those with relapse than for those with remission (p = 0.11). The frequency of positive DIF findings was significantly higher for patients with relapse (p = 0.005). Conclusion: DIF is of better value than ELISA-BP180 and -230 tests to predict relapse after treatment cessation in BP.

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Recommandations des centres de référence des maladies bulleuses auto-immunes pour le diagnostic et la prise en charge de la pemphigoïde bulleuse

Cited by 36 publications

References 0 publications

The Value of BP230 Enzyme-Linked Immunosorbent Assay in the Diagnosis and Immunological Follow-Up of Bullous Pemphigoid

The Value of BP230 Enzyme-Linked Immunosorbent Assay in the Diagnosis and Immunological Follow-Up of Bullous Pemphigoid

Assessment of Bullous Pemphigoid Disease Area Index during Treatment: A Prospective Study of 30 Patients

Positive Direct Immunofluorescence Is of Better Value than ELISA-BP180 and ELISA-BP230 Values for the Prediction of Relapse after Treatment Cessation in Bullous Pemphigoid: A Retrospective Study of 97 Patients

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