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Azathioprine or Mycophenolate Mofetil for Bullous Pemphigoid

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00431119
Recruitment Status : Completed
First Posted : February 5, 2007
Last Update Posted : February 5, 2007
Hoffmann-La Roche
Information provided by:
University Hospital Muenster

Brief Summary:
To investigate the safety and efficacy of oral methylprednisolone combined with azathioprine or mycophenolate mofetil for the treatment of bullous pemphigoid.

Condition or disease Intervention/treatment Phase
Bullous Pemphigoid Drug: Azathioprine or Mycophenolate mofetil Phase 2

Detailed Description:
This multicenter randomized, non-blinded clinical trial compared two parallel groups of patients with bullous pemphigoid treated with oral methylprednisolone in combination with either azathioprine or mycophenolate mofetil. Patients were randomly assigned, irrespective of severity of disease, to receive either 0.5 mg per kg body weight (BW) methylprednisolone (Urbason®, Aventis Pharma, Bad Soden, Germany) with 2 mg per kg BW azathioprine sodium (Imurek®, GlaxoSmithKline, Munich, Germany) once daily or 0.5 mg per kg BW methylprednisolone once daily and 1,000 mg mycophenolate mofetil (CellCept® provided by Hoffmann-La Roche AG, Grenzach-Wyhlen, Germany), given twice daily (2 g/d). The initial dose was maintained until blister formation ceased, crusts as well as erosions disappeared, and re-epithelialization of previous lesions started. The corticosteroid dose was then sequentially reduced by 10 mg every two weeks until a dose of 20 mg per day was reached followed by a reduction in 5 mg-steps every two weeks until 10 mg per day. Afterwards, corticosteroid reduction was performed in 2.5 mg-steps every two weeks until zero. After discontinuation of corticosteroids azathioprine or mycophenolate mofetil doses were maintained at the initial dosage as monotherapy for an additional 4 weeks. Subsequently, azathioprine was reduced by 0.5 mg per kg BW every four weeks to a dose of 100 mg per day. Thereafter, azathioprine was tapered in 25 mg-steps every four weeks until discontinuation of treatment. Mycophenolate mofetil was reduced in 500 mg/d-steps every four weeks to 1,000 mg per day. From then on the mycophenolate mofetil dosage was decreased in 250 mg-steps every four weeks until discontinuation of treatment.

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Study Type : Interventional  (Clinical Trial)
Enrollment : 70 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Comparison of Oral Methylprednisolone Plus Azathioprine or Mycophenolate Mofetil for the Treatment of Bullous Pemphigoid
Study Start Date : October 1997
Study Completion Date : October 2000

Primary Outcome Measures :
  1. The cumulative total methylprednisolone doses and rate of remission.

Secondary Outcome Measures :
  1. Secondary outcome measures were safety profiles and duration of remission.

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 90 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • clinical lesions suggestive of bullous pemphigoid
  • subepidermal blistering upon histological analysis of skin biopsies
  • linear deposition of IgG and C3 along the dermo-epidermal junction
  • deposition of autoantibodies at the blister roof upon split-skin analysis

Exclusion Criteria:

  • treatment with oral or topical corticosteroids, and other immunosuppressive drugs during the previous four weeks

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00431119

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Dermatology, Univ. of Cologne
Cologne, Germany, 50931
Dermatology, Univ. of Dresden
Dresden, Germany, 01307
Dermatology, Univ. of Duesseldorf
Duesseldorf, Germany, 40225
Dermatology, Univ. of Goettingen
Goettingen, Germany, 37075
Dermatology, Univ. Hospital Hannover
Hannover, Germany, 30449
Dermatology, Univ. of Kiel
Kiel, Germany, 24105
Dermatology, Univ. of Magdeburg
Magdeburg, Germany, 39120
Dermatology, Medical Faculty Mannheim, Univ. of Heidelberg
Mannheim, Germany, 68167
Dermatology, Municipal Hospital Minden
Minden, Germany, 32423
Dermatology, Univ. of Ulm
Ulm, Germany, 89081
Dermatology, Univ. of Wuerzburg
Wuerzburg, Germany, 97080
Sponsors and Collaborators
University Hospital Muenster
Hoffmann-La Roche
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Principal Investigator: Stefan Beissert, MD Dermatology, Univ. of Muenster, Germany
Publications automatically indexed to this study by Identifier (NCT Number):
Layout table for additonal information Identifier: NCT00431119    
Other Study ID Numbers: Beissert-BP#1
First Posted: February 5, 2007    Key Record Dates
Last Update Posted: February 5, 2007
Last Verified: February 2007
Keywords provided by University Hospital Muenster:
bullous autoimmune disease
bullous pemphigoid
mycophenolate mofetil
Additional relevant MeSH terms:
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Pemphigoid, Bullous
Skin Diseases, Vesiculobullous
Skin Diseases
Autoimmune Diseases
Immune System Diseases
Mycophenolic Acid
Antibiotics, Antineoplastic
Antineoplastic Agents
Antibiotics, Antitubercular
Antitubercular Agents
Anti-Bacterial Agents
Anti-Infective Agents
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action
Antimetabolites, Antineoplastic
Immunosuppressive Agents
Immunologic Factors
Physiological Effects of Drugs
Antirheumatic Agents