Pemfigus vulgaris tedavisinde yenilikler

Pemfigus vulgaris mortalitesi, tedavi edilmediginde % 90’a kadar ulasabilmektedir. Bu yuksek mortalite orani sistemik kortikosteroidlerin kullanilmaya baslanmasiyla belirgin olarak dusmekle birlikte, siddetli yan etkiler ve direncli olgularin varligi nedeniyle adjuvan tedavi kullanimi hemen her zaman gerekmektedir. Son yillarda pemfigus tedavisinde yeni bir yon vermeyi amaclayan cok fazla calisma yayinlanmaktadir. Amaclanan, olumcul sonuclari olmayan yan etkilere sahip, dusuk dozda kullanilabilen ve uzun sure remisyon saglayan tedavi secenekleri bulmaktir. Sistemik steroidler hizli remisyon saglamalari nedeniyle halen ilk tedavi secenegidir. Ancak bu tedavinin yan etkileri oldukca fazladir ve dozu azaltabilmek amaciyla bir cok toksik yan etkilere sahip adjuvan tedavi eklenmesine gerek duyulmaktadir. Son yillarda pemfigus tedavisine yeni bir yon veren yeni tedaviler; intravenoz immunglobulin (IVIg), plazmaferez, immunoadsorbsiyon (IA), ekstrakorporeal fotokemoterapi (EKP), rituksimab, tumor nekrozis faktor alfa (TNF-α) inhibitorleri (infliksimab ve etanercept), kolinerjik agonistler, dezmoglein 3 peptitleri ve KC706 gibi deneysel ajanlardir. Improvements in the treatment of Pemhigus vulgarism The mortality of Pemphigus vulgaris can reach up to 90% when it is not treated. Although this ratio has declined together with the use of systemic corticosteroids, there is almost always a need to administer adjuvant treatment because of severe adverse effects and resistant cases. There are many publishings aiming to find a new way for pemphigus treatment, recently. No side effects that lead to fatal results and low-dose treatment with long-term remission have become the issue to find. Systemic steroids due to provide fast remission is still the first treatment option. However, depending on the dose and time, side effects are too much. Therefore, almost always an adjuvan treatment is needed to reduce the dose which have many toxic side effects. Pemphigus treatments giving a new direction in recent years are, intravenous immunoglobulin, plasmapheresis, immunoadsorbtion, ekstracorporeal photochemoterapy, rituximab, tumor necrosis factor alpha inhibitors (infliximab and etanercept), cholinergic agonists and experimental agents such as desmoglein 3 peptides and KC706.