The Role of Azathioprine in Preventing Relapse During Prednisolone Reduction Period in Pemphigus Vulgaris Patients


Abstract in English

Background& Objective: pemphigus vulgaris is a life threatening relapsing disease, the first line in its treatment is systemic steroids, and due to the high rate of side effects caused by systemic steroids in pemphigus vulgaris patients ,some immunosuppressant drugs have been introduced as an adjuvant steroid sparing agents , and one of these immunosuppressants is azathioprine, which is the most used drug by therapists, but this use was due to experience and not due to strict studies , this research studies the relationship between azathioprine and relapse in pemphigus vulgaris patients during the prednisolone reduction period. Materials & Methods: 70 pemphigus vulgaris patients have been studied, from the patients of the dermatology university hospital during the period between 1/8/2008 -29/5/2011 (the first year for collecting the sample and the rest for follow-up) they have been divided into 2 groups. The first: were treated with prednisolone plus azathioprine (30 patients ), the second : were treated with prednisolone alone (40 patients ).and after the control of the disease the dose of prednisolone was reduced gradually ,till it was stopped, and patients were observed for relapse. Results: there was no meaningful statistical difference between the two groups in the terms of relapse, as giving azathioprine did not reduce the relapse rate, and did not reduce the prednisolone dose needed to prevent relapse. Conclusion: in this study no use of azathioprine in preventing relapse in pemphigus vulgaris patients, so we advise for more studies to confirm that, and to give more attention during its prescription.

References used

Mimouni D, Anhalt G J, MD; Deborah L,et al.Treatment of Pemphigus Vulgaris and Pemphigus Foliaceus With ycophenolate Mofetil, Arch Dermatol 2003 June; 139: 739-748
BURTON JL, GREAVES MW, MARKS J,et al. Azathioprine in Pemphigus Vulgaris. B Med J 1970; 3: 84- 86
Chams-Davatchi C, Daneshpazhooh M. Prednisolone dosage in pemphigus vulgaris , J AM ACAD DERMATOL 2005;53(3):547
SCULLY C, DE ALMEIDA O.P, PORTER S R, et al , Pemphigus vulgaris: the manifestations and long-term management of 55 patients with oral lesions, B J Dermatol 1999; 140: 84–89
Olszewska M. Risk of disease relapse after treatment discontinuation in pemphigus Vulgaris. J Am Acad Dermatol Feb 2008; AB84

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