An open clinical trial of sulphamethoxypyridazine in the treatment of mucous membrane pemphigoid

Twenty-five patients with mucous membrane pemphigoid (MMP), whose oral lesi ons were unresponsive to topical steroid treatment, were treated with 1 g d aily of sulphamethoxypyridazine (SMXP), a long-acting sulphonamide antibiot ic, in an open prospective clinical trial. Lesion severity was assessed obj ectively in a semiquantitative fashion before treatment and after 14 weeks of treatment. The patient's subjective assessment of the associated pain or discomfort, using a visual analogue scale, was also recorded at these time s. Three patients (12%) were withdrawn from the study owing to side-effects or complications, one due to an allergic reaction, the other two because o f significant haemolysis. For the remainder there was a significant improve ment in the mean objective clinical scores for desquamative gingivitis, oth er oral lesions, conjunctival inflammation, nasal, vulvovaginal and skin in volvement, after 14 weeks treatment with SMXP (all P < 0.001, except skin P < 0.01). Only conjunctival scarring showed no improvement. In addition, th ere was a significant improvement (P < 0.001) in the pain scores for the mo uth, eyes, nose, vulvovaginal region and skin. The results indicate that wi th appropriate monitoring SMXP is an effective treatment for MMP and compar es favourably with other systemic agents used in the management of this con dition.