Review on Pulse Therapy: A Novel Approach in the Treatment of Pemphigus Vulgaris

Abstract

Objective: Pemphigus vulgaris, a fatal autoimmune mucocutaneous disorder commonly seen involving the oral cavity, has since a long time remained a topic of concern regarding its treatment modalities. Pulse therapy, introduced in 1984, employs high-dose corticosteroids along with certain immunosuppressive agents and has gained wide popularity since the last three decades due to its advantage of minimizing the adverse effects of conventional corticosteroid therapy. This article provides a detailed review about various studies conducted utilizing different regimens in pulse therapy and the outcome of these studies. Materials and methods: Information from various studies conducted over the last three decades was collected and a thorough analysis of the results of these studies has been provided in this article. Results: Extensive review of the existing data revealed that pulse therapy minimizes the adverse effects of long-term corticosteroid therapy, controls the disease process faster and has quicker and long-lasting remission rates. Conclusion: Pulse therapy appears to be successful in the treatment of pemphigus vulgaris. Various studies have proven the efficacy of pulse therapy along with reduced side effects of conventional corticosteroid therapy. However, long-term follow-up is necessary to compare the incidence of malignancy in patients receiving pulse doses of immunosuppressive agents with that in patients receiving continuous oral treatment.