A Comparative Study on the Efficacy of i.v. Cyclophosphamide Pulse Versus Oral Cyclophosphamide in Bullous Pemphigoid WC01-WC03
Dr. Rajkumar Kannan,
Flat-C, New No.3, Athipoo Flats, Thiruvalluvar Street, Methanagar, Chennai-600029, India.
Introduction: Bullous pemphigoid is an acquired autoimmune blistering disorder characterised by subepidermal bullae and deposition of complements and antibodies along the basement membrane zone. It most commonly affects the elderly and hence is frequently associated with co-morbidities. Corticosteroids have been the mainstay of treatment.
Aim: To compare the efficacy and safety of i.v. Cyclophosphamide pulse versus oral cyclophosphamide in patients of bullous pemphigoid.
Materials and Methods: The study was conducted in the Department of Dermatology at a tertiary care centre from May 2017 to April 2018. A diagnosis of bullous pemphigoid was made based on the clinical and histopathological findings. A thorough history and detailed physical examination was done. Patientâ€™s demographics, co-morbidities and treatment history were recorded. A total of 15 patients were chosen for the study. They were randomly divided into two groups. Both groups were started on tab. Prednisolone 1 mg/kg/day. In group A eight patients were started on i.v. Cyclophosphamide pulse 500 mg intravenous, at 28 days interval. In group B seven patients were started on tab. Cyclophosphamide 50 mg/day. Patients were followed with periodical complete haemogram, liver function tests and urine analysis monthly during treatment and for a period of 3 months after achieving remission.
Results: I.v. Cyclophosphamide pulse was found to have shorter duration of treatment and lesser cumulative dose when compared to oral cyclophosphamide.
Conclusion: I.v. Cyclophosphamide pulse proves to be an effective drug for bullous pemphigoid than daily oral cyclophosphamide, but warrants close monitoring.