Efficacy and safety of dexamethasone cyclophosphamide pulse therapy in the treatment of pemphigus – An open randomized controlled study

BackgroundVarious drugs used to treat pemphigus can cause remission, but none can provide permanent remission as relapses are common. With the introduction of DCP in pemphigus in 1984, patients started being in prolonged/permanent remission. This study was done to compare the efficacy of DCP to oral corticosteroids and cyclophosphamide in combination.MethodsPatients were allocated into two treatment groups. Group A received treatment with DCP pulse regimen while group B was treated with oral corticosteroids and cyclophosphamide lasting for 4 years.Results18 out of 20 patients in DCP group entered into remission, 1–29 months after complete stoppage of treatment. The two patients relapsed, one in phase III and another in phase IV of DCP. Both were reverted back to phase I and again treated with IV phase regimen of DCP. All the 20 patients in oral corticosteroids and cyclophosphamide group developed repeated relapses (4–6 times) during the study period.ConclusionThis study shows that DCP therapy can put pemphigus into prolonged/permanent remission as compared to corticosteroid-cyclophosphamide group where relapses are frequent. Lately, some dermatologists have questioned the efficacy of DCP in treating pemphigus. However, this could be due to usage of wrong combination of drugs or short study duration.