An Evaluation of Pharmacological Management of Pemphigus Vulgaris and its Impact on Quality of Life

    Published on:October 2018
    Journal of Young Pharmacists, 2018; 10(4):433-438
    Original Article | doi:10.5530/jyp.2018.10.95
    Authors:

    Panchal Kiran M1, Gandhi Anuradha M2*, Patel Prakruti P3, Sutaria Amita4, Desai Mira K5

    1Third Year Resident of Pharmacology, B. J. Medical College and Civil Hospital, Ahmedabad, Gujarat, INDIA.

    2Additional Professor of Pharmacology, B. J. Medical College and Civil Hospital, Ahmedabad, Gujarat, INDIA.

    3Associate Professor of Pharmacology, B. J. Medical College and Civil Hospital, Ahmedabad, Gujarat, INDIA.

    4Assistant Professor, Department of Skin and Venereology, B. J. Medical College and Civil Hospital, Ahmedabad, Gujarat, INDIA.

    5Professor and Head of Department of Pharmacology, B. J. Medical College and Civil Hospital, Ahmedabad, Gujarat, INDIA.

    Abstract:

    Objectives: To study use, effect and adverse drug reaction (ADR) of the drugs and its impact on quality of life in patients suffering from Pemphigus vulgaris (PV). Materials and Methods: Prospective, observational study was carried out in newly diagnosed patients of PV. Baseline and follow-up data at 2, 6 and 12 weeks; disease severity (Kumar’s score), Quality of Life [Dermatology Life Quality Index (DLQI)] and ADR were recorded. Data analyzed by one-way and repeated measure ANOVA test. Results: Total 84 patients were included [Group A: Corticosteroid (n=29), Group B: Corticosteroid + Azathioprine (n=30), Group C: Corticosteroid + rituximab (n=25)]. Significant reduction (P<0.001) observed in Kumar’s and DLQI score at 2nd and 3rd follow-up as compared to baseline and 1st follow up and at 3rd follow-up as compared 2nd follow-up in group A, B and C. Mean difference between baseline and 3rd follow up of Kumar’s score and DLQI was significantly higher in group C as compared to group A (p<0.01 and p<0.001, respectively) and B (p<0.05 and p<0.05, respectively). Correlation between Kumar’s and DLQI score was significant in group C (P<0.05). ADRs were reported in group A (68.96%), B (63.33%) and C (52%). Cost of rituximab was significantly (p<0.001) higher. Conclusion: Corticosteroid with rituximab is associated with better efficacy and improvement in QOL but more expensive than corticosteroid alone / in combination with azathioprine for the treatment of Pemphigus vulgaris.

    Key words: Pemphigus vulgaris, Kumar’s score, Dermatology life Quality Index, Corticosteroid, Rituximab.

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