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Comparison of three different dose regimens of methylprednisolone as initial therapy for pemphigus vulgaris of moderate severity: A single‐center retrospective study from Turkey
Author(s) -
Polat Ekinci Algün,
Kiliç Sayar Sıla,
Babuna Kobaner Goncagül,
Küçükoğlu Rıfkiye
Publication year - 2021
Publication title -
australasian journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.67
H-Index - 53
eISSN - 1440-0960
pISSN - 0004-8380
DOI - 10.1111/ajd.13560
Subject(s) - medicine , methylprednisolone , pemphigus vulgaris , pemphigus , corticosteroid , retrospective cohort study , cumulative dose , regimen , adverse effect , dosing , single center , gastroenterology , surgery , dermatology
Background Currently, no consensus exists on the dosing regimen of corticosteroids in relation to disease severity in pemphigus vulgaris. Objective To evaluate the efficacy of three initial dose regimens of methylprednisolone in the treatment of moderate pemphigus. Methods We retrospectively analysed the data of 46 patients with moderate pemphigus vulgaris, who initially received either low (0.60–0.80 mg/kg/day), moderate (0.81–1.20 mg/kg/day) or high (1.21–2.0 mg/kg/day) doses of methylprednisolone. Results The median time to disease control and hospital stay was shortest in the high‐dose group (8.5 days and 27.5 days, respectively). The low‐dose group had the highest rate of adjuvant therapy (88.8%, P = 0.035). Cumulative methylprednisolone doses and corticosteroid‐related adverse events were similar in the moderate‐ and high‐dose groups. The initial methylprednisolone dose showed a significant inverse correlation with time to disease control ( r = −0.319, P = 0.031) and a weak inverse correlation with length of hospital stay ( r = −0.282, P = 0.058). Limitations Retrospective design and small patient size are major limitations. Conclusion In the treatment of moderate pemphigus vulgaris, high initial doses of corticosteroid seem to provide early disease control and shortened hospital stay without notable increases in cumulative corticosteroid doses. This treatment strategy may lower the risk for nosocomial infections and reduce the economic burden of pemphigus.