Your QuestionAre there medications besides prednisone which can successfully treat pemphigus? What about "alternative" medical treatments?
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Pemphigus is a group of rare autoimmune diseases that cause blistering of the skin and mucous membranes (mouth, nose, throat, eyes, and genitals). This condition can occur at any age, but often strikes people in middle or older age. It is more common in people of Middle Eastern or Jewish descent than in other races and cultures. Pemphigus is a chronic disease which is best controlled by early diagnosis and treatment. Treatment includes steroids to reduce inflammation, drugs that suppress the immune system response and antibiotics to treat associated infections.
There are three main types of pemphigus:
High-dose oral corticosteroids, such as prednisone or prednisolone, are the main treatment for pemphigus. These are anti-inflammatory medicines that suppress the immune system. High doses are often required to bring pemphigus under control. To keep the levels of corticosteroid use to a minimum, immunosuppressive drugs are often added to a patient’s treatment. These drugs stop or slow down the immune system’s response to what it sees as an attack on the body. They include:
Once controlled, the steroid is reduced slowly to minimize side effects. Some patients then go into remission; however, many patients need a small maintenance dose to keep the disease under control.
People with severe pemphigus that cannot be controlled with corticosteroids may undergo plasmapheresis, a treatment in which the blood containing the damaging antibodies is removed and replaced with blood that is free of antibodies. Such patients can also be treated with IVIg, or intravenous immunoglobulin, which is given daily for 3 to 5 days, every 2 to 4 weeks for 1 to several months. Plasmapheresis and IVIg are both very expensive treatments, since they require large amounts of donated and specially processed blood. Scientists have reported success in treating difficult cases of pemphigus vulgaris with a combination of IVIg and rituximab, a cancer medication.
- Gold injections
- Antibiotics such as tetracycline, minocycline, or doxycycline in combination with niacinamide
- Biologics - several of these drugs (rituximab/Rituxan®, infliximab/Remicade®, eterancept/Enbrel®) are in clinical trial.
To learn more about new medications being studied for the treatment of pemphigus, visit the ClinicalTrials.gov web site.
- Pemphigus. National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). 2007; http://www.niams.nih.gov/Health_Info/Pemphigus/default.asp. Accessed 3/3/2010.
- Pemphigus. MayoClinic.com. 2008; http://www.mayoclinic.com/print/pemphigus/DS00749/METHOD=print&DSECTION=all. Accessed 3/3/2010.
- Pemphigus. MedlinePlus. 2010; http://www.nlm.nih.gov/medlineplus/pemphigus.html. Accessed 3/3/2010.
- Pemphigus. International Pemphigus & Pemphigoid Foundation. 2010; http://www.pemphigus.org/index.php?option=com_content&view=article&id=364&Itemid=100073. Accessed 3/3/2010.