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

TY - JOUR

T1 - World Workshop on Oral Medicine VI

T2 - a systematic review of the treatment of mucocutaneous pemphigus vulgaris

AU - McMillan, R

AU - Taylor, J

AU - Shephard, M

AU - Ahmed, R

AU - Carrozzo, M

AU - Setterfield, J

AU - Grando, S

AU - Mignogna, M

AU - Kuten-Shorrer, M

AU - Musbah, T

AU - Elia, A

AU - McGowan, R

AU - Kerr, A R

AU - Greenberg, M S

AU - Hodgson, T

AU - Sirois, D

N1 - Copyright © 2015 Elsevier Inc. All rights reserved.

PY - 2015/8

Y1 - 2015/8

N2 - 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.

AB - 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.

KW - Humans

KW - Mouth Diseases

KW - Pemphigus

KW - Remission Induction

U2 - 10.1016/j.oooo.2015.01.022

DO - 10.1016/j.oooo.2015.01.022

M3 - Article

C2 - 25934414

SN - 2212-4411

VL - 120

SP - 132-42.e61

JO - Oral surgery, oral medicine, oral pathology and oral radiology

JF - Oral surgery, oral medicine, oral pathology and oral radiology

IS - 2

ER -