A nonrandomized comparison of the clinical outcome of ocular involvement in patients with mucous membrane (cicatricial) pemphigoid between conventional immunosuppressive and intravenous immunoglobulin therapies

The purpose of this study was to compare the clinical outcomes of intravenous immunoglobulin (IVIg) therapy to conventional immunosuppressive therapy in patients with mucous membrane pemphigoid (MMP), also known as cicatricial pemphigoid (CP), whose disease progressed to involve the eye. Before ocul...

Ausführliche Beschreibung

Bibliographische Detailangaben
Veröffentlicht in:Clinical immunology (Orlando, Fla.). - 1999. - 111(2004), 3 vom: 01. Juni, Seite 303-10
1. Verfasser: Letko, Erik (VerfasserIn)
Weitere Verfasser: Miserocchi, Elisabetta, Daoud, Yassine J, Christen, William, Foster, C Stephen, Ahmed, A Razzaque
Format: Aufsatz
Sprache:English
Veröffentlicht: 2004
Zugriff auf das übergeordnete Werk:Clinical immunology (Orlando, Fla.)
Schlagworte:Clinical Trial Comparative Study Journal Article Immunoglobulins, Intravenous Immunosuppressive Agents
LEADER 01000naa a22002652 4500
001 NLM148714307
003 DE-627
005 20231223050159.0
007 tu
008 231223s2004 xx ||||| 00| ||eng c
028 5 2 |a pubmed24n0496.xml 
035 |a (DE-627)NLM148714307 
035 |a (NLM)15183151 
040 |a DE-627  |b ger  |c DE-627  |e rakwb 
041 |a eng 
100 1 |a Letko, Erik  |e verfasserin  |4 aut 
245 1 2 |a A nonrandomized comparison of the clinical outcome of ocular involvement in patients with mucous membrane (cicatricial) pemphigoid between conventional immunosuppressive and intravenous immunoglobulin therapies 
264 1 |c 2004 
336 |a Text  |b txt  |2 rdacontent 
337 |a ohne Hilfsmittel zu benutzen  |b n  |2 rdamedia 
338 |a Band  |b nc  |2 rdacarrier 
500 |a Date Completed 02.08.2004 
500 |a Date Revised 15.11.2006 
500 |a published: Print 
500 |a Citation Status MEDLINE 
520 |a The purpose of this study was to compare the clinical outcomes of intravenous immunoglobulin (IVIg) therapy to conventional immunosuppressive therapy in patients with mucous membrane pemphigoid (MMP), also known as cicatricial pemphigoid (CP), whose disease progressed to involve the eye. Before ocular involvement, all the patients in this study were diagnosed and treated with immunosuppressive agents, for biopsy-proven MMP, affecting the skin and/or mucous membranes, other than the conjunctiva. Eight patients in group A were treated with IVIg after the diagnosis of ocular cicatricial pemphigoid (OCP) was established. The efficacy and safety of IVIg therapy were compared to a clinically similar group of eight patients treated with conventional immunosuppressive therapy (group B). The inclusion criteria for both groups were: (1). presence of MMP at extraocular sites confirmed by biopsy before entry into the study; (2). entry into the study occurred when ocular involvement was noted and confirmed by biopsy; (3). presence of conventional immunosuppressive therapy at the time of ocular involvement; (4). a minimum of 18 months of follow-up after diagnosis of ocular involvement. The mean length of the therapy, after the onset of ocular involvement, was 24 months (range 16-30) in group A and 45 months (range 21-90) in group B. The median time between initiation of therapy and clinical remission in group A and group B was 4 and 8.5 months, respectively. This difference was statistically significant (P < 0.01). No recurrence of ocular inflammation was recorded in any of the patients in group A. On the contrary, at least one recurrence (median 1) was recorded in five patients in group B (range 0-4). This difference was statistically significant (P < 0.05). All eight patients in group A and group B presented to the ophthalmologist in stage 2 of OCP at the time of the initial visit. At the last follow-up visit, no progression to advanced stages of OCP was recorded in all eight patients in group A. On the contrary, only four patients in group B remained in stage 2 of OCP at the last follow-up exam. The conjunctival scaring progressed from stage 2 to stage 3 in the remaining four patients of group B. At the last follow-up visit, both eyes of each patient in group A were free of inflammation. Some level of conjunctival inflammation at the last follow-up visit was noted in five patients in group B (range 0-1.5, P < 0.05). Both groups of patients were studied during the same time period. The results of this study suggest that ocular involvement in patients with MMP may be considered an indication for initiating IVIg therapy, since it was more effective in arresting progression of OCP, when compared to conventional immunosuppressive therapy. These data indicate that IVIg produced a faster control of the acute inflammation and that no recurrences were observed during the follow-up. This clinical difference could be because of the reduced production of pathogenic antibody, and/or restoration of the immunoregulation, which may have been disturbed 
650 4 |a Clinical Trial 
650 4 |a Comparative Study 
650 4 |a Journal Article 
650 7 |a Immunoglobulins, Intravenous  |2 NLM 
650 7 |a Immunosuppressive Agents  |2 NLM 
700 1 |a Miserocchi, Elisabetta  |e verfasserin  |4 aut 
700 1 |a Daoud, Yassine J  |e verfasserin  |4 aut 
700 1 |a Christen, William  |e verfasserin  |4 aut 
700 1 |a Foster, C Stephen  |e verfasserin  |4 aut 
700 1 |a Ahmed, A Razzaque  |e verfasserin  |4 aut 
773 0 8 |i Enthalten in  |t Clinical immunology (Orlando, Fla.)  |d 1999  |g 111(2004), 3 vom: 01. Juni, Seite 303-10  |w (DE-627)NLM098196855  |x 1521-7035  |7 nnns 
773 1 8 |g volume:111  |g year:2004  |g number:3  |g day:01  |g month:06  |g pages:303-10 
912 |a GBV_USEFLAG_A 
912 |a SYSFLAG_A 
912 |a GBV_NLM 
912 |a GBV_ILN_11 
912 |a GBV_ILN_24 
912 |a GBV_ILN_350 
951 |a AR 
952 |d 111  |j 2004  |e 3  |b 01  |c 06  |h 303-10