An Evaluation of Pharmacological Management of Pemphigus Vulgaris and its Impact on Quality of Life

Objectives: To study use, effect and adverse drug reaction (ADR) of the drugs and its impact on quality of life in patients suffering from Pemphigus vulgaris (PV). Materials and Methods: Prospective, observational study was carried out in newly diagnosed patients of PV. Baseline and follow-up data at 2, 6 and 12 weeks; disease severity (Kumar’s score), Quality of Life [Dermatology Life Quality Index (DLQI)] and ADR were recorded. Data analyzed by one-way and repeated measure ANOVA test. Results: Total 84 patients were included [Group A: Corticosteroid (n=29), Group B: Corticosteroid + Azathioprine (n=30), Group C: Corticosteroid + rituximab (n=25)]. Significant reduction (P<0.001) observed in Kumar’s and DLQI score at 2nd and 3rd follow-up as compared to baseline and 1st follow up and at 3rd follow-up as compared 2nd follow-up in group A, B and C. Mean difference between baseline and 3rd follow up of Kumar’s score and DLQI was significantly higher in group C as compared to group A (p<0.01 and p<0.001, respectively) and B (p<0.05 and p<0.05, respectively). Correlation between Kumar’s and DLQI score was significant in group C (P<0.05). ADRs were reported in group A (68.96%), B (63.33%) and C (52%). Cost of rituximab was significantly (p<0.001) higher. Conclusion: Corticosteroid with rituximab is associated with better efficacy and improvement in QOL but more expensive than corticosteroid alone / in combination with azathioprine for the treatment of Pemphigus vulgaris.