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World Workshop on Oral Medicine VI: a systematic review of the treatment of mucocutaneous pemphigus vulgaris

Lookup NU author(s): Professor Marco Carrozzo

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Abstract

Objective. To determine the efficacy and safety of interventions for pemphigus vulgaris (PV).Study Design. We conducted a systematic review from 2003 to 2013 according to the Cochrane Collaboration methodology. Randomized controlled trials (RCTs) or controlled clinical trials (CCTs) and observational studies were conducted along with diagnosis confirmed by clinical, histopathologic, and immunofluorescence criteria. Primary outcomes were disease remission and mortality; several relevant secondary outcomes were also included.Results. Fourteen RCTs or CCTs and 110 observational studies were included in the final analyses. RCTs or CCTs demonstrated considerable heterogeneity in outcome measures, and all had a high risk of bias for at least 1 of 8 domains. Of the studies, 96.8% (120) described the use of oral corticosteroids. Azathioprine and mycophenolate-mofetil were the most commonly cited treatments. An increasing number of studies described biologic therapies (rituximab, intravenous immunoglobulin [IVIg]). Evidence supporting recent comprehensive treatment guidelines was reviewed.Conclusions. We found persisting wide variations in treatment practice and inadequate quality of research supporting optimal PV treatment.

Publication metadata

Author(s): Carrozzo M; McMillan R; Taylor J; Shephard M; Ahmed R; Setterfield J; Grando S; Mignogna M; Kuten-Shorrer M; Musbah T; Elia A; McGowan R; Kerr AR; Greenberg MS; Hodgson T; Sirois D

Publication type: Article

Publication status: Published

Journal: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

Year: 2015

Volume: 120

Issue: 2

Pages: 132-142

Print publication date: 01/08/2015

Online publication date: 09/03/2015

Acceptance date: 01/01/2015

ISSN (print): 2212-4403

ISSN (electronic): 1528-395X

Publisher: Elsevier

URL: http://dx.doi.org/10.1016/j.oooo.2015.01.022

DOI: 10.1016/j.oooo.2015.01.022

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