2004 Volume 114 Issue 14 Pages 2341-2350
The effects of cyclosporine, an immunosuppresant, were studied in five Japanese patients suffering from mucocutaneous type pemphigus vulgaris (PV-MC). All patients have proceeded to medium-to-high doses of oral prednisolone (PSL) (40–60 mg/day), but still remained inadequently controllable and had persisted oral and/or cutaneous manifestations or lesions frequently relapsed. Their clinicopathological features were assessed after oral administration of cyclosporine (CYA) (4–4.8 mg/kg/day) in combination with on-going steroid therapy. Most patients (4/5, 80%) made an impression of achieving to reduce daily dosages of PSL compairing before and after treatment. Particularly in patients with relapsed disease (2/2, 100%) the clinical activity dramatically decreased within 19 days of the combined therapy. Furthermore as assessed by ELISA specific for desmogleins 1 and 3, the serum antibody titers in all five subjects became low within 12–57 days (mean±SD, 34.6±18.0 days) after CYA administration, and subsequently negative (3/5, 60%). No obvious side effects were noted during the combination therapy. The CYA combination therapy may thus be one of the treatment options in pemphigus patients who are unresponsive to standard steroid monotherapy.
