INTRODUCTION
Bullous pemphigoid (BP) is the most common autoimmune blistering disease. Most prevalent in the eighth and ninth decades of life, the incidence of BP continues to increase.1 Owing to its association with considerable morbidity and diminished quality of life, it is important to treat BP appropriately and sometimes aggressively.1,2
Mycophenolate mofetil (MMF), which is an inosine-monophosphate-dehydrogenase inhibitor with several anti-inflammatory properties, may be useful in BP as an alternative to systemic glucocorticoids.3 However, current evidence supporting the use of MMF in the treatment of BP consists only of case reports and small case series, and most studies have only examined MMF’s efficacy in conjunction with systemic glucocorticoids.4-6 We present a retrospective chart review of 26 patients with BP, who were treated with MMF as monotherapy or as dual therapy combined with glucocorticoids, from our tertiary referral center.
Mycophenolate mofetil (MMF), which is an inosine-monophosphate-dehydrogenase inhibitor with several anti-inflammatory properties, may be useful in BP as an alternative to systemic glucocorticoids.3 However, current evidence supporting the use of MMF in the treatment of BP consists only of case reports and small case series, and most studies have only examined MMF’s efficacy in conjunction with systemic glucocorticoids.4-6 We present a retrospective chart review of 26 patients with BP, who were treated with MMF as monotherapy or as dual therapy combined with glucocorticoids, from our tertiary referral center.
MATERIALS AND METHODS
The NYU Langone Health institutional review board approved this retrospective chart review and waived the need for informed consent for the use of deidentified data. Individuals, who were age 18 or older, diagnosed with BP with diagnostic skin biopsy specimen and positive autoantibodies to BP180 and/or BP230, and treated with MMF between 2013 and 2017, were included. Patients were grouped based on whether they received MMF therapy alone (monotherapy) or MMF combined with prednisone at some point during their treatment course (dual therapy).
MMF was initiated at 500 or 1000 mg twice daily (BID) and increased to a maximal individual effective dose by increments of 500 mg BID each month. The highest dose used was 3000 mg BID. Response to treatment was based on patient interviews and examinations that were performed during office visits. Improvement was indicated by a decrease in pruritus and/or a decrease in number and frequency of new skin lesions or bullae.
MMF was initiated at 500 or 1000 mg twice daily (BID) and increased to a maximal individual effective dose by increments of 500 mg BID each month. The highest dose used was 3000 mg BID. Response to treatment was based on patient interviews and examinations that were performed during office visits. Improvement was indicated by a decrease in pruritus and/or a decrease in number and frequency of new skin lesions or bullae.
