Pemphigus Vulgaris Remission Seen With Strategic Steroid Tapering
(HealthDay News) — For patients with pemphigus vulgaris, a severity-tailored starting dose of glucocorticoids with an initial tapering duration based on the starting dose and a subsequent 50% yearly tapering regimen can result in complete remission within three to six years, according to a study published online September 1 in the Journal of Dermatology.
Mingyue Wang, MD, PhD, from Peking University First Hospital in Beijing, and colleagues summarized a therapeutic schedule with glucocorticoids in 140 patients with pemphigus vulgaris.
The researchers found that 124 patients achieved complete remission off or on a prednisone dose of ≤10mg/day for six months or more. For mucosal-dominant patients, and the mild, moderate, severe, and extensive cutaneous-involved patients, the mean average steroid controlling doses were 0.65, 0.62, 0.80, 1.08, and 1.38mg/kg per day, respectively (P<0.001). For the cutaneous-involved types, the mean durations of the initial tapering after controlled doses started were 77.98, 48.78, 31.74, and 28.83 days when the disease was controlled with doses of ≤40, 45 to 60, 65 to 80, and >80mg/day, respectively (P<0.005). Overall, complete remission was achieved by 79.51% within three years, 98.36% within five years, and in all patients within six years, corresponding to a 50% yearly reduction in glucocorticoid dose.
"A strategy involving categorized initial doses and initial tapering followed by a 50%-off yearly reduction regimen is practical and effective for treating pemphigus vulgaris with glucocorticoids," the authors write.