Enteric-coated mycophenolate sodium in the treatment of refractory pemphigus.

Abstract

BACKGROUND:

One of the major goals of pemphigus therapy is to reduce the patient's cumulative exposure to systemic corticosteroids. To investigate the efficacy of enteric-coated mycophenolate sodium (EC-MPS), 10 patients with active, refractory pemphigus vulgaris (PV) or foliaceous (PF) were treated with EC-MPS (1440 mg daily) and prednisone (75 mg daily) over 18 months.

OBSERVATIONS:

Following EC-MPS/prednisone therapy, disease progression was inhibited between days 30 and 45 in 9/10 patients (8 PV; 1 PF). At 18 months, 8/9 PV patients had clinically quiescent disease; EC-MPS therapy was no longer required in two patients as a result of disease remission. The remaining PV patient showed no response to treatment. The PF patient also had clinically quiescent disease but with high levels of anti-desmoglein-1. ECMPS dose was reduced to 720 mg daily in 4/9 patients by month 6. Average daily prednisone requirement decreased to 25 mg at 6 months and to 15 mg at 18 months. Three adverse events were reported: headache (two cases; one mild and one moderate) and significant increase in blood glucose (one case; moderate).

CONCLUSIONS:

Enteric-coated mycophenolate sodium is effective and safe as an adjuvant therapy in patients with refractory pemphigus and may be effective even in patients whose disease is unresponsive to azathioprine.

• Authors: Maria Rita Bongiorno, Giuseppe Pistone, Spyridoula Doukaki, Mario Aricò
• Journal: International journal of dermatology (Int J Dermatol) Vol. 49 Issue 6 Pg. 693-9 (Jun 2010) ISSN: 1365-4632 [Electronic] England
• PMID: 20618478 (Publication Type: Journal Article)

Chemical References

• Glucocorticoids
• Immunosuppressive Agents
• Tablets, Enteric-Coated
• Mycophenolic Acid
• Prednisone

Topics

• Administration, Oral
• Adult
• Drug Therapy, Combination
• Female
• Follow-Up Studies
• Glucocorticoids (administration & dosage, adverse effects)
• Humans
• Immunosuppressive Agents (administration & dosage, adverse effects)
• Male
• Middle Aged
• Mycophenolic Acid (administration & dosage, adverse effects, analogs & derivatives)
• Pemphigus (drug therapy)
• Prednisone (administration & dosage, adverse effects)
• Tablets, Enteric-Coated
• Treatment Outcome