Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Dermatol Ther. 2019 Sep;32(5):e13057. doi: 10.1111/dth.13057. Epub 2019 Aug 20.
Steroid pulse therapy has shown satisfactory efficacy and safety in treating pemphigus vulgaris (PV). However, there is a paucity of data about the efficacy and safety of methylprednisolone, despite its frequent administration. The aim of this study is to evaluate the efficacy and safety of steroid pulse therapy in treating PV. In this 10-year retrospective cohort study, 312 patients with PV, who had received methylprednisolone pulse therapy, were included. Data of pulse therapy sessions, adjuvant medications, dosages, remission rates, complications, and mortalities were collected from all patients. A total of 276 patients out of 312 underwent the final follow-up at least 6 months after the last session of pulse therapy. Complete remission off therapy was achieved in 83 patients (30%), and 152 patients (55%) had complete remission on therapy. About 29 (10.5%) patients had lesions of pemphigus at the time of the study follow-up, and 26.8% of remained patients were on the minimal therapy. Methylprednisolone pulse therapy could be considered as an option for proper control of PV in severe cases. It might lead to shorter periods of hospitalization and reduce the need to take long-term high-dose oral steroid therapy.
脉冲式类固醇疗法在治疗寻常型天疱疮(PV)方面已显示出满意的疗效和安全性。然而,尽管甲泼尼龙常被使用,但关于其疗效和安全性的数据却很少。本研究旨在评估脉冲式类固醇疗法治疗 PV 的疗效和安全性。在这项为期 10 年的回顾性队列研究中,共纳入 312 例接受甲泼尼龙脉冲疗法的 PV 患者。收集所有患者的脉冲治疗次数、辅助药物、剂量、缓解率、并发症和死亡率等数据。312 例患者中有 276 例至少在最后一次脉冲治疗后 6 个月进行了最终随访。83 例患者(30%)停药后完全缓解,152 例患者(55%)治疗中完全缓解。在研究随访时,约有 29 例(10.5%)患者有天疱疮病变,26.8%的仍在接受最低剂量治疗。对于严重的 PV 患者,脉冲式甲泼尼龙疗法可被视为一种适当的控制选择。它可能会缩短住院时间,减少长期服用大剂量口服类固醇治疗的需求。