Open AccessEfficacy of combination therapy of steroid and methotrexate for refractory pemphigus
Author(s) -
Kanaoka Miwa,
Matsukura Setsuko,
Okawa Tomoko,
Nakamura Kazuko,
Takahashi Kazuo,
Aihara Michiko
Publication year - 2021
Publication title -
journal of cutaneous immunology and allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.127
H-Index - 1
ISSN - 2574-4593
DOI - 10.1002/cia2.12175
Subject(s) - methotrexate , pemphigus , medicine , refractory (planetary science) , adverse effect , steroid , dermatology , pharmacology , hormone , physics , astrobiology
The first line of treatment for pemphigus is systemic corticosteroids. When steroids alone do not result in remission, additional immunosuppressants are recommended. Twenty‐two patients with pemphigus vulugris were treated with steroids and other immunomodulators. However, they were refractory, and hence, methotrexate (MTX) was administered. The efficacy of MTX was assessed for 16 patients who were able to continue MTX therapy for 1 year. Steroid dose reduction was possible in 11 patients. One patient with severe infections had diabetes and was elderly. Our results suggested that MTX was useful as a steroid‐sparing agent in treating recalcitrant pemphigus, when an initial immunosuppressant treatment had failed. However, adverse effects should be closely monitored.