PMID- 37000702
OWN - NLM
STAT- MEDLINE
DCOM- 20230404
LR  - 20230912
IS  - 1536-4798 (Electronic)
IS  - 0277-3740 (Linking)
VI  - 42
IP  - 5
DP  - 2023 May 1
TI  - A 10-Year Review of the Management of Ocular Mucous Membrane Pemphigoid: A 
      Private Practice Experience.
PG  - 565-571
LID - 10.1097/ICO.0000000000003071 [doi]
AB  - PURPOSE: Ocular mucous membrane pemphigoid (OcMMP) is a rare and potentially 
      blinding condition for which consensus treatment guidelines do not exist. The 
      purpose of this study was to assess the effectiveness and safety of various 
      immunomodulatory agents in the treatment of OcMMP in a private practice setting. 
      METHODS: We conducted a 10-year retrospective chart review of patients managed 
      with OcMMP (n = 22). The median age at diagnosis was 73 (range: 35-91) years, and 
      59% (13/22) of patients were female. Visual acuity, Foster stage, and adverse 
      effects (AEs) were documented. Treatment outcomes for each treatment episode were 
      qualified at 3 months as complete response (CR), response (R), or failure (F). 
      After 3 months, CR was then further subqualified as sustained CR, reactivation 
      after initial CR, or AE after initial CR. The Fisher exact test P values were 
      calculated for each outcome in comparison with mycophenolate. RESULTS: Twenty 
      patients were treated with an immunomodulatory agent for a total of 55 treatment 
      episodes. In comparison to dapsone, mycophenolate was more likely to achieve 
      sustained CR (50% vs. 0%, P = 0.022) and R (100% vs. 50%, P = 0.007), and less 
      likely to fail (0% vs. 50%, P = 0.007). Dapsone was also more likely to be 
      discontinued because of AEs than mycophenolate (40% vs. 6%, P = 0.041). 
      CONCLUSIONS: Mycophenolate is a superior first-line agent to dapsone in the 
      treatment of OcMMP. Although not statistically significant, mycophenolate trends 
      toward superiority over methotrexate as well. Mycophenolate is very effective 
      when used in combination with rituximab. Azathioprine remains a reasonable 
      second-line agent.
CI  - Copyright (c) 2022 Wolters Kluwer Health, Inc. All rights reserved.
FAU - Johnson, Kasey B
AU  - Johnson KB
AUID- ORCID: 0000-0002-7978-069
AD  - Washington State University, Elson S. Floyd College of Medicine, Spokane, WA.
FAU - Rosenbaum, James T
AU  - Rosenbaum JT
AD  - Oregon Health and Science University, Casey Eye Institute, School of Medicine, 
      Portland, OR.
AD  - Legacy Health System, Devers Eye Institute, Portland, OR.
FAU - Yarter, Jason T
AU  - Yarter JT
AD  - University of Washington, School of Medicine, Spokane, WA; and.
FAU - Broadbent, Talmage
AU  - Broadbent T
AD  - Northwest Eyelid and Orbital Specialists, Spokane, WA.
FAU - Michels, Kevin S
AU  - Michels KS
AD  - Washington State University, Elson S. Floyd College of Medicine, Spokane, WA.
AD  - Northwest Eyelid and Orbital Specialists, Spokane, WA.
LA  - eng
PT  - Journal Article
DEP - 20220613
PL  - United States
TA  - Cornea
JT  - Cornea
JID - 8216186
RN  - 0 (Immunosuppressive Agents)
RN  - 8W5C518302 (Dapsone)
SB  - IM
MH  - Humans
MH  - Female
MH  - Male
MH  - Retrospective Studies
MH  - *Pemphigoid, Bullous/chemically induced
MH  - Immunosuppressive Agents/therapeutic use
MH  - *Pemphigoid, Benign Mucous Membrane/diagnosis/drug therapy
MH  - Mucous Membrane
MH  - Dapsone/therapeutic use
COIS- J. T. Rosenbaum consults for Gilead, AbbVie, Novartis, Roche, Revolo, Corvus, and 
      Horizon. He receives research support from Pfizer and Horizon. He receives 
      royalties from UpToDate. He serves on a data monitoring committee for 
      Celgene-Bristol Myers. The remaining authors have no funding or conflicts of 
      interest to disclose.
EDAT- 2023/04/01 06:00
MHDA- 2023/04/04 06:42
CRDT- 2023/03/31 13:33
PHST- 2022/01/10 00:00 [received]
PHST- 2022/04/12 00:00 [accepted]
PHST- 2023/04/04 06:42 [medline]
PHST- 2023/03/31 13:33 [entrez]
PHST- 2023/04/01 06:00 [pubmed]
AID - 00003226-202305000-00006 [pii]
AID - 10.1097/ICO.0000000000003071 [doi]
PST - ppublish
SO  - Cornea. 2023 May 1;42(5):565-571. doi: 10.1097/ICO.0000000000003071. Epub 2022 
      Jun 13.