The International Journal of Dermatology published the results of a three-year retrospective patient study aimed at comparing treatment regimens for bullous pemphigoid.
The aim of the study was to compare treatment regimens for bullous pemphigoid with tetracycline 500 mg three times daily, nicotinamide 400 mg three times daily, and 0.05% clobetasol cream topically (TNC regimen) versus prednisolone.
The study included 106 patients, 59 were treated with the TNC regimen and 47 received prednisolone at a dosage of 0.5 mg/kg per day. The mean time to achieve disease control was 7 days in both groups. Survival at 1 year and 3 years was higher with the TNC regimen (83% and 71.2%, respectively) compared with traditional prednisolone treatment (65.9% and 48%, respectively; P = 0.042 and P = 0.019, respectively). In patients with lesions greater than 30% of body surface area, prednisolone treatment resulted in faster remission than TNC therapy (39 versus 58 days; P = 0.02), although the 3-year mortality rate in the prednisolone-treated group was 70% (versus 36% with TNC; P = 0.04).
TNC may be an effective alternative treatment because this regimen has demonstrated better survival rates than prednisolone in patients with bullous pemphigoid. The importance of the results is that they show the possibility of anti-inflammatory, immunomodulatory treatments for bullous pemphigoid, which may be particularly useful for patients with contraindications to conventional immunosuppressive therapy.