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Therapy Changes During Pemphigus Management: A Retrospective Analysis

Pemphigus diseases are rare, and the treatment response differs between patients. Several therapy changes are often required to achieve disease control and avoid unwanted side effects. We aimed to analyze the treatment courses of pemphigus patients and the clinical responses regarding therapy change...

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Autores principales: Scarpone, Roberta, Francuzik, Wojciech, Worm, Margitta, Heine, Guido
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7732666/
https://www.ncbi.nlm.nih.gov/pubmed/33330538
http://dx.doi.org/10.3389/fmed.2020.581820
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author Scarpone, Roberta
Francuzik, Wojciech
Worm, Margitta
Heine, Guido
author_facet Scarpone, Roberta
Francuzik, Wojciech
Worm, Margitta
Heine, Guido
author_sort Scarpone, Roberta
collection PubMed
description Pemphigus diseases are rare, and the treatment response differs between patients. Several therapy changes are often required to achieve disease control and avoid unwanted side effects. We aimed to analyze the treatment courses of pemphigus patients and the clinical responses regarding therapy changes. Pemphigus patients in our center were retrospectively examined according to the medication and dosage, disease activity, reason for treatment changes, and autoantibody concentrations. Therapy changes due to insufficient therapeutic effects or side effects were analyzed. Seventy-seven pemphigus patients with repeated consultations were identified (81% pemphigus vulgaris, 19% pemphigus foliaceus). Disease control was achieved in 66 patients (86%; score “almost clear” or “clear”), with an average of 4 different therapy regimens (range 1–18 changes), after an average of 2 years of treatment (range 0–11 years). Twenty-two patients (29%) with refractory disease received rituximab, of which 19 (86%) subsequently achieved remission. Anti-desmoglein-1 and−3 concentrations correlated with disease severity, but not with the number of treatment changes. The identification of an effective and safe therapy for the individual pemphigus patient is a challenge and often requires time, which is reflected by a high number of therapy changes. Predictive parameters are warranted to directly identify the safest and most efficient treatment regimen for an individual patient.
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spelling pubmed-77326662020-12-15 Therapy Changes During Pemphigus Management: A Retrospective Analysis Scarpone, Roberta Francuzik, Wojciech Worm, Margitta Heine, Guido Front Med (Lausanne) Medicine Pemphigus diseases are rare, and the treatment response differs between patients. Several therapy changes are often required to achieve disease control and avoid unwanted side effects. We aimed to analyze the treatment courses of pemphigus patients and the clinical responses regarding therapy changes. Pemphigus patients in our center were retrospectively examined according to the medication and dosage, disease activity, reason for treatment changes, and autoantibody concentrations. Therapy changes due to insufficient therapeutic effects or side effects were analyzed. Seventy-seven pemphigus patients with repeated consultations were identified (81% pemphigus vulgaris, 19% pemphigus foliaceus). Disease control was achieved in 66 patients (86%; score “almost clear” or “clear”), with an average of 4 different therapy regimens (range 1–18 changes), after an average of 2 years of treatment (range 0–11 years). Twenty-two patients (29%) with refractory disease received rituximab, of which 19 (86%) subsequently achieved remission. Anti-desmoglein-1 and−3 concentrations correlated with disease severity, but not with the number of treatment changes. The identification of an effective and safe therapy for the individual pemphigus patient is a challenge and often requires time, which is reflected by a high number of therapy changes. Predictive parameters are warranted to directly identify the safest and most efficient treatment regimen for an individual patient. Frontiers Media S.A. 2020-11-25 /pmc/articles/PMC7732666/ /pubmed/33330538 http://dx.doi.org/10.3389/fmed.2020.581820 Text en Copyright © 2020 Scarpone, Francuzik, Worm and Heine. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Medicine
Scarpone, Roberta
Francuzik, Wojciech
Worm, Margitta
Heine, Guido
Therapy Changes During Pemphigus Management: A Retrospective Analysis
title Therapy Changes During Pemphigus Management: A Retrospective Analysis
title_full Therapy Changes During Pemphigus Management: A Retrospective Analysis
title_fullStr Therapy Changes During Pemphigus Management: A Retrospective Analysis
title_full_unstemmed Therapy Changes During Pemphigus Management: A Retrospective Analysis
title_short Therapy Changes During Pemphigus Management: A Retrospective Analysis
title_sort therapy changes during pemphigus management: a retrospective analysis
topic Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7732666/
https://www.ncbi.nlm.nih.gov/pubmed/33330538
http://dx.doi.org/10.3389/fmed.2020.581820
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