Mycophenolate mofetil as an adjuvant drug for the treatment of pemphigus vulgaris and pemphigus foliaceus

Abstract

Background: Pemphigus is a rare autoimunne bullous disease, characterized by blisters and erosions of the skin and/or mucous membranes. Its potentially life-threatening condition has been modified after the introduction of systemic corticosteroids. However, the long-term use of corticosteroids may lead to serious adverse effects. Mycophenolate mofetil has been used as a corticosteroid-sparing agent in the treatment of pemphigus. Objectives: To evaluate the effectiveness and safety of mycophenolate mofetil as adjuvant therapy in patients with pemphigus vulgaris and foliaceus. Methods: The study analyzed 23 patients diagnosed as pemphigus vulgaris (N = 17) or pemphigus foliaceus (N = 6), who had failed to previous treatments or experienced significant adverse effects with azathioprine, and were treated with mycophenolate mofetil. We also performed indirect immunofluorescence before andafter introduction of Mycophenolate Mofetil. Results: Remission wasachieved in 20 out of 23 patients (87%), and was characterized as follows: complete remission off therapy (N = 2), complete remission on minimal therapy (N = 6), partial remission on therapy (N = 6) and partial remission on minimal therapy (N = 6). Failure occurred in three out of 23 patients. Mycophenolate mofetil was well tolerated, once 20 out of 23 patients had no adverse effects. Conclusion: Mycophenolate mofetil has been demonstrated to be an effective and safe adjuvant drug in the treatment of pemphigus vulgaris and foliaceus, who had failed to previous treatments or experienced significant adverse effects with azathioprine.