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Dapsone, Sulfasalazine Beneficial as Adjuvants in Pemphigus Vulgaris

Evidence from review supports efficacy of dapsone and sulfasalazine as adjuvant therapies

By Dermsquared Editorial Team | January 31, 2024

WEDNESDAY, Jan. 31, 2024 -- Dapsone and sulfasalazine are beneficial adjuvant therapies in pemphigus vulgaris, according to a review published in the January issue of SKIN.

Kevin H. Nguyen, from the College of Osteopathic Medicine of the Pacific in Pomona, California, and colleagues examined the use of dapsone and sulfasalazine in the treatment of pemphigus vulgaris in a systematic review. All studies with three or more patients were reviewed; clinical improvement was defined as disease control or complete remission and as a reduction of corticosteroids to ≤7.5 mg/day when adjuvant therapy was initiated in uncontrolled and controlled disease, respectively.

Data were included from 11 studies with 75 patients treated with dapsone and 66 with sulfasalazine. The researchers found that all six patients who received dapsone monotherapy had clinical improvement. Sixty-nine patients received adjuvant dapsone; clinical improvement occurred in 58 percent. Eighty-six percent of the 57 patients receiving sulfasalazine as an adjuvant to intravenous corticosteroids had clinical improvement. All nine patients receiving sulfasalazine after rituximab showed clinical improvement.

"Although our conclusions are limited by the largely retrospective nature of studies included, our review synthesizes existing evidence for dapsone and sulfasalazine -- two potentially underutilized adjuvant therapies that clinicians can add to their arsenal when managing pemphigus vulgaris," the authors write.

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