Effect of intravenous immunoglobulin on prednisone dose in patients with pemphigus vulgaris.

Mittmann, Nicole; Chan, Brian; Knowles, Sandra; Mydlarski, P Régine; Cosentino, Lidia; Shear, Neil

BACKGROUND Current therapeutic options for the treatment of pemphigus vulgaris (PV) are prednisone and immunosuppressants. Patients unresponsive to high-dose systemic corticosteroids and conventional immunosuppressants may respond to intravenous immunoglobulin (IVIG). OBJECTIVE The primary outcome was the change in prednisone dose at 6 months and 1 year post-IVIG administration. METHODS A retrospective chart review of PV patients treated at Sunnybrook and Women's College Health Sciences Centre between January 1999 and October 2004 was conducted. Demographic information, corticosteroid and IVIG use, dosage, and the timing of administration for all patients were obtained. RESULTS Eight PV patients, mean age of 50 years (+/- 14.7 years), were reviewed. There was a significant decrease in mean prednisone dose at 6 months (45%) and 12 months (71%) compared with the mean dose at the start of treatment (p < .05). LIMITATIONS Concomitant medication use may influence results. CONCLUSION This study demonstrates that IVIG can lower prednisone doses in PV patients.