Tetracycline Antibiotics and Niacinamide as Steroid-Sparing Agents for Pemphigus

A dermatologist describes his experience using these low-toxicity, steroid-sparing agents.

Until the advent of systemic corticosteroids, pemphigus was a life-threatening disease. Because of steroid-related toxicity at the doses required for pemphigus treatment, early use of a steroid-sparing agent has become standard practice. Tetracycline antibiotics may have some anti-inflammatory effects, and the addition of niacinamide has been useful in other immunoblistering diseases. The exact mechanism by which these agents might affect immune response in pemphigus is unknown.

These authors reviewed the cases of pemphigus patients treated at a single medical dermatology practice for at least 3 months with a combination of a tetracycline antibiotic (tetracycline, doxycycline, or minocycline) and niacinamide after corticosteroid-induced clin…

Reviewing Author

Jeffrey P. Callen, MD

Disclosures

Consultant / Advisory board XOMA; Eli Lilly; Celgene

Equity Various trust accounts

Editorial boards JAMA Dermatology; UpToDate

Leadership positions in professional societies Association of Professors of Dermatology (President-Elect)