Retrospective Analysis of a Single- Kuwaiti Center Clinical Experience Toward Development of Proper Controlling Treatment of 84 Pemphigus Patients with a Long-Term Follow-Up: Efficacy and Safety of the Multidrug Protocol Combining Intravenous Immunoglobulin with the Cytotoxic Immunosuppressor Drugs

Abstract

Pemphigus is the name of a group of autoimmune pathological entities characterized by the formation of intraepithelial blisters in the skin and/or mucosa. Pemphigus vulgaris (PV) and Pemphigus foliaceus (PF) are considered as classical forms. Rare, non-classical forms of Pemphigus include: Pemphigus herpetiformis, IgA pemphigus, Paraneoplastic pemphigus, IgG/IgA pemphigus. Aim: Aim of our study is to explore the prognostic influence of clinical, immunological and therapeutic drugs on disease course and remission in different pemphigus variants in Kuwait and to establish a safe and effective multidrug protocol. Plan of the study is to make a correlation between epidemiological factors, therapy used and clinical and immunological remission, as well as, follow up of comorbidities in our patients. 84 patients were evaluated, from 1st January 1990 to 31st December 2013. IVIG is used as a third-line adjuvant treatment initially flanked by high-dose systemic corticosteroids and steroid- sparing immune-suppressants. Thus, this multidrug IVIG regimen made it possible to achieve a rapid control of the pemphigus symptoms, with progression to a stable disease remission, while maintenance an overall safety of treatment.