 |
|
Controlled Trial of Azathioprine and Plasma Exchange in Addition to Prednisolone in the Treatment of Bullous Pemphigoid
Jean-Claude Guillaume, MD;
Loïc Vaillant, MD;
Philippe Bernard, MD;
Catherine Picard, MD;
Catherine Prost, MD;
Bruno Labeille, MD;
Bernard Guillot, MD;
Christine Foldès-Pauwels, MD;
François Prigent, MD;
Pascal Joly, MD;
Florence Cordoliani, MD;
Véronique Salagnac, MD;
Laurent Machet, MD;
Jean-Claude Aldigier, MD;
Béatrice Crickx, MD;
Jean-Claude Roujeau, MD
Arch Dermatol. 1993;129(1):49-53.
Abstract
| |
 Background and Design.—
Bullous pemphigoid is usually treated with systemic corticosteroids. Side effects are common in elderly patients, justifying the search for adjuvant therapy. This randomized, multicentric unblind study was designed to assess the efficacy of azathioprine or plasma exchange when added to conventional doses of prednisolone. One hundred patients with active disease entered the study. They were randomly allocated to receive 28 days of treatment with oral prednisolone sodium metasulfobenzoate (1 mg/kg per day) either alone or in combination with oral azathioprine (100 to 150 mg/d) or four large-volume plasma exchanges. After 28 days, the prednisolone doses were progressively decreased according to the same strict regimen in the three groups (in combination with oral azathioprine in group 2).
Results.—
The clinical results were evaluable in 98 of the evaluable patients included in the study. There was no appreciable difference in the percentages of complete remission of the disease in the three therapeutic groups at 28 days (71%, 80%, and 71%, respectively) or at 6 months (42%, 39%, and 29%, respectively). Severe complications were more often observed among patients receiving azathioprine. At 6 months, 14 of 98 patients had died, without any differences noted among the three study groups.
Conclusions.—
We conclude that neither azathioprine nor plasma exchange is effective enough to be used routinely as an adjuvant to corticosteroids in the management of bullous pemphigoid.
(Arch Dermatol. 1993;129:49-53)
Author Affiliations
From the Departments of Dermatology, Hôpital H. Mondor, Créteil, France (Drs Guillaume, Prost, and Roujeau), Hôpital Trousseau, Tours, France (Drs Vaillant and Machet), Hôpital Dupuytren, Limoges, France (Drs Bernard and Aldigier), Hôpital Bichat, Paris, France (Drs Picard and Crickx), Hôpital Sud, Amiens, France (Dr Labeille), Hôpital St Charles, Montpellier, France (Dr Guillot), Hôpital de St-Germain-en-Laye (France) (Dr Foldès-Pauwels), Hôpital St-Louis, Paris, France (Dr Cordoliani), Hôpital de St Cloud (France) (Dr Prigent), Hôpital C. Nicolle, Rouen, France (Dr Joly), Hôpital Sebastopol, Reims, France (Dr Salagnac).
Footnotes
Accepted for publication August 27, 1992.
Reprint requests to Service de Dermatologie, Hôpital H. Mondor, 94010 Créteil, France (Dr Roujeau).
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Risk Factors for Relapse in Patients With Bullous Pemphigoid in Clinical Remission: A Multicenter, Prospective, Cohort Study
Bernard et al.
Arch Dermatol 2009;145:537-542.
ABSTRACT
| FULL TEXT
A Retrospective Analysis of Patients With Bullous Pemphigoid Treated With Methotrexate
Kjellman et al.
Arch Dermatol 2008;144:612-616.
ABSTRACT
| FULL TEXT
A Comparison of Oral Methylprednisolone Plus Azathioprine or Mycophenolate Mofetil for the Treatment of Bullous Pemphigoid
Beissert et al.
Arch Dermatol 2007;143:1536-1542.
ABSTRACT
| FULL TEXT
Prediction of Survival for Patients With Bullous Pemphigoid: A Prospective Study
Joly et al.
Arch Dermatol 2005;141:691-698.
ABSTRACT
| FULL TEXT
Risk Factors for Lethal Outcome in Patients With Bullous Pemphigoid: Low Serum Albumin Level, High Dosage of Glucocorticosteroids, and Old Age
Rzany et al.
Arch Dermatol 2002;138:903-908.
ABSTRACT
| FULL TEXT
A Systematic Review of Treatments for Bullous Pemphigoid
Khumalo et al.
Arch Dermatol 2002;138:385-389.
ABSTRACT
| FULL TEXT
A Comparison of Oral and Topical Corticosteroids in Patients with Bullous Pemphigoid
Joly et al.
NEJM 2002;346:321-327.
ABSTRACT
| FULL TEXT
Bullous Pemphigoid Therapy -- Think Globally, Act Locally
Stern
NEJM 2002;346:364-367.
FULL TEXT
Prednisone Is More Effective Than Prednisolone Metasulfobenzoate in the Treatment of Bullous Pemphigoid
Lebrun-Vignes et al.
Arch Dermatol 1999;135:89-90.
FULL TEXT
Bullous Pemphigoid: The Latest in Diagnosis, Prognosis, and Therapy
Korman
Arch Dermatol 1998;134:1137-1141.
FULL TEXT
High Risk of Death in Elderly Patients With Extensive Bullous Pemphigoid
Roujeau et al.
Arch Dermatol 1998;134:465-469.
ABSTRACT
| FULL TEXT
Failure of Plasmapheresis in the Treatment of Recalcitrant Skin Ulcers in a Patient With Mixed Cryoglobulinemia
Machet et al.
Arch Dermatol 1997;133:389-390.
ABSTRACT
Erythema Elevatum Diutinum Associated With IgA Paraproteinemia Successfully Controlled With Intermittent Plasma Exchange
Chow et al.
Arch Dermatol 1996;132:1360-1364.
ABSTRACT
Management of Acquired Bullous Skin Diseases
Fine
NEJM 1995;333:1475-1484.
FULL TEXT
Incidence and Distribution of Subepidermal Autoimmune Bullous Skin Diseases in Three French Regions
Bernard et al.
Arch Dermatol 1995;131:48-52.
ABSTRACT
Controlled Trial of Azathioprine and Plasma Exchange in Addition to Prednisolone in the Treatment of Bullous Pemphigoid
Anstey
Arch Dermatol 1993;129:1203-1204.
ABSTRACT
Adjuvant Therapy for Bullous Pemphigoid: No Benefit
Journal Watch Dermatology 1993;1993:1-1.
FULL TEXT
|
