What are the treatment options for Pemphigus Vulgaris?
I was diagnosed with Pemphigus Vulgaris via a Biopsy in Jan 2018. I'm currently taking Prednisolone and Azathioprine to control the symptoms which are mainly in my oral cavity (gums). I have also been offered Rituximab, which I'm told is effective. However, I find this to be costly. Are there any other treatment options available for Pemphigus Vulgaris?
Sorry to hear about your diagnosis of pemphigus vulgaris. Pemphigus vulgaris is an autoimmune condition where the body produces an antibody against desmoglein, which is the a protein that cements the skin cells together. This results in skin fragility and blisters and erosions on the skin or oral mucosa.
The mainstay of treatment for pemphigus vulgaris involves the use of oral steroids and immunosuppressive agents. Oral steroids have long-term side effects and usually fairly high doses of steroids are required to control this .
Other immunosuppressive agents like is azathioprine, mycophenolate mofetil and cyclophosphamide can also be used. These agents do have their own set of side effects but help to achieve reduction in the steroid doses.
Rituximab is a biologic treatment and is one of the more effective treatments for pemphigus vulgaris. It can cause immunosuppression and is a costly treatment, but in cases of stubborn or resistant pemphigus, it is a good option.
You should ask your attending doctor about the risks/benefits of the different option. I am sure they will be more than happy to discuss this with you.