Treatment of pemphigus vulgaris and pemphigus foliaceus with mycophenolate mofetil.
Treatment of pemphigus vulgaris and pemphigus foliaceus with mycophenolate mofetil.
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DOI：
10.1001/archderm.139.6.739
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发表时间：
2003-06
影响因子：
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通讯作者：
D. Mimouni;G. Anhalt;Deborah L. Cummins;D. Kouba;Jennifer E. Thorne;H. Nousari
中科院分区：
文献类型：
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作者：
D. Mimouni;G. Anhalt;Deborah L. Cummins;D. Kouba;Jennifer E. Thorne;H. Nousari
背景吗替麦考酚酯越来越多地被用作免疫抑制方案中的皮质类固醇节省剂。目的探讨霉酚酸酯辅助治疗寻常型天疱疮和落叶型天疱疮的疗效。设计历史前瞻性研究。环境大学医院。该研究包括42名连续的天疱疮患者（31名寻常型天疱疮和11名落叶型天疱疮），他们在泼尼松逐渐减量期间复发或因先前的药物治疗而有临床显著的不良反应。结果22例（71%）寻常型天疱疮和5例（45%）落叶型天疱疮患者获得缓解。分别有1例（3%）和4例（36%）获得部分缓解。达到完全缓解的中位时间为9个月（范围，1-13个月）。治疗的中位时间为22个月，中位随访期为22个月。77%的患者没有不良反应。两名患者的副作用严重到必须停止治疗，一个是因为有症状但可逆的中性粒细胞减少症，另一个是因为恶心。结论霉酚酸酯辅助治疗寻常型天疱疮和落叶型天疱疮均安全有效。
BACKGROUND Mycophenolate mofetil is increasingly being used as a corticosteroid-sparing agent in immunosuppressive regimens. OBJECTIVE To elucidate the effectiveness of mycophenolate as adjuvant therapy in the treatment of both pemphigus vulgaris and pemphigus foliaceus. DESIGN Historical prospective study. SETTING University hospital. PATIENTS The study included 42 consecutive patients with pemphigus (31 with pemphigus vulgaris and 11 with pemphigus foliaceus) who had relapses during prednisone taper or had clinically significant adverse effects from previous drug therapy. RESULTS Remission was achieved in 22 (71%) and 5 (45%) of patients with pemphigus vulgaris and pemphigus foliaceus, respectively. Partial remission was achieved in 1 (3%) and 4 (36%), respectively. The median time to achieve complete remission was 9 months (range, 1-13 months). The treatment was administered for a median of 22 months, and the median follow-up period was 22 months. Seventy-seven percent of patients had no adverse effect. Two patients had side effects severe enough to necessitate discontinuation of treatment, one because of symptomatic but reversible neutropenia and the other because of nausea. CONCLUSION Mycophenolate is an effective and safe adjuvant in the treatment of both pemphigus vulgaris and pemphigus foliaceus.