Pemphigus vulgaris: benefits of tetracycline as adjuvant therapy in a series of thirteen patients

Background Tetracycline is an antibiotic which has been proven beneficial a s an immunomodulating drug in the treatment of autoimmune bullous diseases. Methods Thirteen hospitalized patients with pempigus vulgaris received tetr acycline 2 g/day for 1 month, then 1 g/day for the following 4 weeks. Predn isone 0.5-1 mg/kg/day was then gradually reduced. The control group consist ed of seven patients with pemphigus who had received prednisone and azathio prine. Results A total of 13 patients in the study group achieved cessation of new blister formation within 5.4 days, compared to 23.71 days (p < 0.0001). Th e average initial dose of prednisone was 76.53 mg/day for the study group a nd 118.57 mg/day in the control group (p < 0.014). The average number of da ys before reduction of the prednisone dosage could begin was 16.53 days for the study group compared to 31.28 days in the control (p < 0.049). Total h ospitalization time was also significantly lower: 34.07 days (p < 0.001). T he clinical response was not linked to the location of lesions nor to sever ity of disease. Conclusions Tetracycline was shown to be effective as an adjuvant therapy f or pemphigus with low toxicity and safety.