Guignant Marine, Tedbirt Billal, Murrell Dedee F, Amagai Masayuki, Aoki Valeria, Bauer Johannes, Ciancinni Giuseppe, Culton Donna, Daneshpazhooh Maryam, De Dipankar, Fairley Janet, Hall Russell, Kim Soo-Chan, Korman Neil J, Kowalewski Cezary, Mimouni Daniel, Patsatsi Aikaterini, Hebert Vivien, Saleh Marwah Adly Mohamed, Schmidt Enno, Sprecher Eli, Uzun Soner, Venning Vanessa, Werth Victoria P, Zillikens Detlef, Joly Pascal
Department of Dermatology, Rouen University Hospital, Rouen, France.
INSERM Unit 2345, French Reference Center for Autoimmune Bullous Diseases, Normandie University, Rouen, France.
JID Innov. 2022 Apr 12;2(4):100129. doi: 10.1016/j.xjidi.2022.100129. eCollection 2022 Jul.
Many treatments are currently proposed for treating patients with bullous pemphigoid (BP). We assessed treatment modalities of BP depending on the different countries, BP extent, and patients' comorbidities. We surveyed worldwide experts about how they treat patients with BP. A total of 61 experts from 27 countries completed the survey. Severe and moderate BP were treated with oral prednisone (61.4 and 53.7%, respectively) or superpotent topical corticosteroids (CSs) (38.6 and 46.3%, respectively). Conventional immunosuppressants were more frequently combined with oral prednisone (74.5%) than with superpotent topical CS (37.5%) in severe BP. Topical CSs were mainly used in Europe in mild (81.1%), moderate (55.3%), and severe (54.3%) BP. In the United States of America and Asia, systemic CSs were mainly proposed for treating severe (77.8 and 100%, respectively), moderate (70 and 77.8%, respectively), and also mild (47.1 and 33.3%, respectively) BP. Most experts reduced the initial dose of oral CS in patients with diabetes mellitus (48.1%) or cardiac insufficiency (40.2%) but rarely changed BP treatment in patients with neurological disorders or neoplasia. This survey showed major differences in the way patients with BP are treated between AmeriPac countries (United State of America, Latin America, and Australia) and Asia on the one hand and Europe and the Middle East on the other hand.
目前针对大疱性类天疱疮（BP）患者提出了许多治疗方法。我们根据不同国家、BP的严重程度以及患者的合并症评估了BP的治疗方式。我们就如何治疗BP患者对全球专家进行了调查。来自27个国家的61位专家完成了该调查。重度和中度BP分别采用口服泼尼松治疗（分别为61.4%和53.7%）或超强效外用糖皮质激素（CSs）治疗（分别为38.6%和46.3%）。在重度BP中，传统免疫抑制剂与口服泼尼松联合使用（74.5%）的频率高于与超强效外用CS联合使用（37.5%）。外用CSs主要在欧洲用于轻度（81.1%）、中度（55.3%）和重度（54.3%）BP。在美国和亚洲，全身用CSs主要用于治疗重度BP（分别为77.8%和100%）、中度BP（分别为70%和77.8%）以及轻度BP（分别为47.1%和33.3%）。大多数专家降低了糖尿病患者（48.1%）或心脏功能不全患者（40.2%）口服CS的初始剂量，但很少改变神经系统疾病或肿瘤患者的BP治疗方案。这项调查显示，在BP患者的治疗方式上，一方面美洲-太平洋地区国家（美国、拉丁美洲和澳大利亚）与亚洲之间，另一方面欧洲和中东之间存在重大差异。
