Treatment of pemphigus vulgaris with cyclosporine

Abstract

Eight patients (two males and six females), between 35 and 67 years of age (mean age 52.7 years), with pemphigus vulgaris resistant to corticosteroids and azathioprine or in whom such treatments had provoked severe side-effects, were treated with cyclosporine. The drug was administered at a starting dosage ranging between 3 and 5 mg/kg per day. This dosage was gradually reduced to the minimum effective dosage ranging between 2 and 5 mg/kg per day. In all patients prednisone was also used. Complete remission was observed in five patients, partial remission in one and no response in two. Side-effects and laboratory abnormalities were mild and transitory: in only one patient with severe gingival hyperplasia was it necessary to reduce the dosage of cyclosporine. This drug can be used, in combination with prednisone, in patients with pemphigus vulgaris who are resistant to traditional treatments or in whom such treatments give rise to severe side-effects. Furthermore, cyclosporine allows a reduction of the dosage of prednisone (in our study by about one-third) and therefore, theoretically, the number and severity of side-effects caused by prednisone itself.

Key Words:

• Pemphigus vulgaris
• Cyclosporine