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

R. McMillan, J. Taylor, M. Shephard, R. Ahmed, M. Carrozzo, J. Setterfield, S. Grando, M. Mignogna, M. Kuten-Shorrer, T. Musbah, A. Elia, R. McGowan, A. R. Kerr, M. S. Greenberg, T. Hodgson, D. Sirois

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
Pages (from-to)132-142.e61
JournalOral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Volume120
Issue number2
DOIs
StatePublished - 2015

ASJC Scopus subject areas

  • Surgery
  • Oral Surgery
  • Pathology and Forensic Medicine
  • Dentistry (miscellaneous)
  • Radiology Nuclear Medicine and imaging

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