Which medications in the drug class Immunosuppressive agents are used in the treatment of Pemphigus Vulgaris?

Updated: Jun 14, 2018
  • Author: Bassam Zeina, MD, PhD; Chief Editor: Dirk M Elston, MD  more...
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Answer

Immunosuppressive agents

Immunosuppressive agents are useful adjuvants in patients with pemphigus vulgaris with generalized disease unresponsive to steroids and/or other anti-inflammatory agents or in patients unable to tolerate prednisone. Some suggest measuring levels of thiopurine methyltransferase (TPMT), a key enzyme in azathioprine metabolism, before starting patients on azathioprine.

Azathioprine (Imuran)

Azathioprine antagonizes purine metabolism and inhibits the synthesis of DNA, RNA, and proteins. It may decrease the proliferation of immune cells, which results in lower autoimmune activity. In conjunction with prednisone, it is more effective than prednisone alone. OFf-label use of azathioprine may be an effective monotherapy in mild cases, although therapeutic effects are delayed 3-5 weeks. Consider withdrawal if no improvement is seen within 3 months.


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