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

Abstract

<p style="text-align: justify;"><strong>Objectives:</strong> 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). <strong>Materials and Methods:</strong> 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&rsquo;s score), Quality of Life [Dermatology Life Quality Index (DLQI)] and ADR were recorded. Data analyzed by one-way and repeated measure ANOVA test. <strong>Results:</strong> Total 84 patients were included [Group A: Corticosteroid (n=29), Group B: Corticosteroid + Azathioprine (n=30), Group C: Corticosteroid + rituximab (n=25)]. Significant reduction (<em>P</em>&lt;0.001) observed in Kumar&rsquo;s and DLQI score at 2^nd and 3^rd follow-up as compared to baseline and 1^st follow up and at 3^rd follow-up as compared 2^nd follow-up in group A, B and C. Mean difference between baseline and 3^rd follow up of Kumar&rsquo;s score and DLQI was significantly higher in group C as compared to group A (<em>p</em>&lt;0.01 and <em>p</em>&lt;0.001, respectively) and B (<em>p</em>&lt;0.05 and <em>p</em>&lt;0.05, respectively). Correlation between Kumar&rsquo;s and DLQI score was significant in group C (<em>P</em>&lt;0.05). ADRs were reported in group A (68.96%), B (63.33%) and C (52%). Cost of rituximab was significantly (<em>p</em>&lt;0.001) higher. <strong>Conclusion:</strong> 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. <p style="text-align: justify;"><strong>Key words:</strong> Pemphigus vulgaris, Kumar&rsquo;s score, Dermatology life Quality Index, Corticosteroid, Rituximab.