Journal of Cutaneous Immunology and Allergy (Oct 2021)

Efficacy of combination therapy of steroid and methotrexate for refractory pemphigus

  • Miwa Kanaoka,
  • Setsuko Matsukura,
  • Tomoko Okawa,
  • Kazuko Nakamura,
  • Kazuo Takahashi,
  • Michiko Aihara

DOI
https://doi.org/10.1002/cia2.12175
Journal volume & issue
Vol. 4, no. 5
pp. 123 – 127

Abstract

Read online

Abstract The first line of treatment for pemphigus is systemic corticosteroids. When steroids alone do not result in remission, additional immunosuppressants are recommended. Twenty‐two patients with pemphigus vulugris were treated with steroids and other immunomodulators. However, they were refractory, and hence, methotrexate (MTX) was administered. The efficacy of MTX was assessed for 16 patients who were able to continue MTX therapy for 1 year. Steroid dose reduction was possible in 11 patients. One patient with severe infections had diabetes and was elderly. Our results suggested that MTX was useful as a steroid‐sparing agent in treating recalcitrant pemphigus, when an initial immunosuppressant treatment had failed. However, adverse effects should be closely monitored.

Keywords