Original articleThe role of adjuvant therapy in pemphigus: A systematic review and meta-analysis
Section snippets
Methods
The systematic review and meta-analysis were conducted and reported in accordance with the PRISMA statement.8 The review protocol was registered on PROSPERO and can be accessed at: www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42014014160.
Only studies that met the following criteria were included in the analysis:
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RCTs of combined GC plus adjuvant treatment for PV, PF, or both compared with oral GCs alone or with a placebo.
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Inclusion of patients of any age with PV or PF diagnosed according
Results
The literature search yielded 261 titles and abstracts (Fig 1). Eleven trials fulfilled the eligibility criteria, including 10 original publications11, 12, 13, 14, 15, 16, 17, 18, 19, 20 and 1 follow-up report of an already included trial combined with the initial trial data.11, 21 Characteristics of included trials are detailed in Table I. They included a total of 559 patients, 516 with PV and 43 with PF. All study patients were adults; 54% to 72% were female. Six trials included patients with
Discussion
The aim of this review was to determine whether the common practice of adding adjuvant therapy to oral GCs is justified. Our results showed that adjuvant therapy did not increase the number of patients who achieved remission. However, it had significant added value for other important outcomes. The addition of adjuvant therapy was associated with a decrease in relapses, such that 12 patients needed to be treated with adjuvant therapy to prevent 1 relapse with oral GCs alone. Specifically MMF,
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Funding sources: None.
Conflicts of interest: None declared.