Long term Effectiveness of Treatment for Oral Pemphigus Vulgaris with Systemic Corticosteroids and Azathioprine
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Abstract
The aim of this study was to compare the safety, tolerability and efficacy of corticosteroid and corticosteroid combined with azathioprine in oral pemphigus vulgaris patients.
In this study, data of 47 patients with oral pemphigus vulgaris were evaluated and statistically analyzed during a 14-year period (2004-2018).
All patients started treatment with oral prednisolone 1mg/kg/d (group I). 22 patients who did not respond to this treatment in 6 weeks time were placed on a combination regimen consisting of prednisolone 1mg/ kg/d with 100 mg azathioprine twice daily (group II). All patients were referred every two weeks for medication tapering, evaluation of side effects, lesion examination and follow-up. The time to recovery was considered as the time from treatment to the first follow up session where all lesions had recovered and no new lesions had formed.
Results: Both groups showed a high degree of favorable clinical response. That is complete treatment was seen in 13 patients (52%) of group I and 13 patients (59.1%) of group II. The mean time to recovery was 163.96 days for group I, and 134.24 days for group II.
Only one patient did not show response to any treatment. However, the comparison of side effects in the two groups in this study showed that the side effects of drug use were significantly lower in the combination diet group.( Complications in group one were 80% and in group two 50% P = 0.030)
Both treatments were effective. In patients with less severe disease, systemic corticosteroids are preferable to combination regimens. Because of this, the unknown effects of adding immunosuppressive drugs to the patient cannot be imposed. However, when the disease is more severe, the combined regimen can be used effectively and safely to treat the disease and prevent the patient from being exposed to higher doses of prednisone and its adverse effects.
Key words: Pemphigus vulgaris, Corticosteroids, Azathioprine, Treatment outcome
