Ocular Cicatricial Pemphigoid: Methotrexate as an Initial Treatment?
REUMATOLOGIA CLINICA 2021;
18:S1699-258X(20)30242-4. [PMID:
33454207 DOI:
10.1016/j.reuma.2020.10.005]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 09/21/2020] [Accepted: 10/15/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVE
To analyse the clinical / epidemiological data, the management and the treatments established in patients with ocular cicatricial pemphigoid in a Rheumatology Service.
MATERIAL AND METHODS
Review of clinical histories of patients with ocular cicatricial pemphigoid referred by ophthalmology between 2008 and 2019.
RESULTS
In our series of 27 patients, 67% were diagnosed and referred in the last 2 years. Most in Foster stage 1. Of the patients, 18.5% presented associated Sjogren's syndrome, with poor progression: 88.8% received Methotrexate, 74% used it as monotherapy and 66% continued with said treatment up to the end. Eighteen point five percent had to combine or rotate therapies, the drugs used were mycophenolate, azathioprine, cyclophosphamide, sirolimus, etanercept, rituximab: 29% used steroids. Only in 2 eyes was stage progression observed. There were no serious adverse events, and 37% had mild adverse events.
CONCLUSION
Starting immunosuppressive therapy early is essential, methotrexate being a good initial alternative in our experience, and treatment must be escalated in line with disease progression.
Collapse