1. Doxycycline versus prednisolone as an initial treatment strategy for bullous pemphigoid: a pragmatic, non-inferiority, randomised controlled trial
- Author
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John R. Ingram, H K Bell, Gudula Kirtschig, B Walker, Fiona Antony, M Walsh, Eva-B. Bröcker, Ingrid Salvary, J Wee, Emilia Duarte-Williamson, H Santander, Kathy Taghipour, David Gawkrodger, Enno Schmidt, Sam Gibbs, Alison M Layton, Michael Sticherling, J Adams, M Vatve, Joanne R Chalmers, Hywel C Williams, Fiona Craig, S Blackford, A Carmichael, Walter Bottomley, Adzura Azam, Chris Lovell, Karen E. Harman, Margaret Childs, Alexander Vincent Anstey, K. Hussain, Marinella Nik, C Günthert, A. Chapman, N. van Beek, Andrew M Wright, Rainer Hügel, C Barnard, Indre Verpetinske, K Davies, Thomas A. Luger, A Omerod, Karen Gibbon, Alex Waters, V Akhras, Robert Charles-Holmes, Shyamal Wahie, John C. English, James Mason, R.R. Coelho, Girish Khandubhai Patel, Robert Ellis, Jane C. Sterling, A Lloyd Lavery, Thomas R. Godec, Fenella Wojnarowska, Jane Ravenscroft, Richard Groves, H Malhomme, Kerstin Steinbrink, Andrew J. Nunn, Regine Gläser, Emma Veysey, Adam Ferguson, V Lewis, Diane Whitham, V Venning, M Westmoreland, G Wong, Chris Bower, N. Hepburn, C Thomas, P J Hampton, R. Wachsmuth, Andrew Ilchyshyn, Nick J. Levell, M G S Dunnill, S. Walton, and R Rallan
- Subjects
Adult ,Male ,medicine.medical_specialty ,Pemphigoid ,medicine.medical_treatment ,Prednisolone ,RL ,Administration, Oral ,Equivalence Trials as Topic ,law.invention ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,Germany ,Internal medicine ,Pemphigoid, Bullous ,medicine ,Initial treatment ,Humans ,skin and connective tissue diseases ,Glucocorticoids ,Aged ,Aged, 80 and over ,Doxycycline ,Medicine(all) ,Clinical Trials as Topic ,integumentary system ,business.industry ,Standard treatment ,General Medicine ,Articles ,Middle Aged ,medicine.disease ,R1 ,Dermatology ,United Kingdom ,Anti-Bacterial Agents ,Treatment Outcome ,030220 oncology & carcinogenesis ,Female ,Bullous pemphigoid ,business ,Adjuvant ,medicine.drug - Abstract
BACKGROUND: Bullous pemphigoid is a blistering skin disorder with increased mortality. We tested whether a strategy of starting treatment with doxycycline gives acceptable short-term blister control while conferring long-term safety advantages over starting treatment with oral corticosteroids. METHODS: We did a pragmatic, multicentre, parallel-group randomised controlled trial of adults with bullous pemphigoid (three or more blisters at two or more sites and linear basement membrane IgG or C3). Participants were randomly assigned to doxycycline (200 mg per day) or prednisolone (0·5 mg/kg per day) using random permuted blocks of randomly varying size, and stratified by baseline severity (3-9, 10-30, and >30 blisters for mild, moderate, and severe disease, respectively). Localised adjuvant potent topical corticosteroids (
- Published
- 2017