Treatment of ocular cicatricial pemphigoid with sulfasalazine

Purpose: To assess the outcome of patients with ocular cicatricial pemphigo id (OCP) treated with sulfasalazine as an alternative to dapsone. Design: Retrospective noncomparative case series. Participants: Nine patients with biopsy-proven OCP and previous dapsone-rel ated adverse effects (hemolysis and gastrointestinal disturbances) treated with oral sulfasalazine. Methods: Clinical data were abstracted from patients' medical records. Main Outcome Measures: Patients' symptoms, ocular inflammation, conjunctiva l scarring, complete blood cell count (including reticulocyte count). Results: At the initiation of sulfasalazine therapy, ocular inflammation wa s controlled in all patients but one. Mean follow-up was 12 months (range, 2-35 months). Median oral sulfasalazine dosage was 3 g (range, 1-4 g). The disease remained controlled with sulfasalazine alone in four patients (45%) . Two patients (22%) required adjunctive oral cyclophosphamide. Adverse eff ects necessitating drug withdrawal occurred in three patients (33%): hemoly sis in two and gastrointestinal disturbances in one. Conclusions: Sulfasalazine may be useful in OCP patients with previous daps one-related adverse effects. (C) 2001 by the American Academy of Ophthalmol ogy.