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Oral corticosteroids effectively induce remission in patients with bullous pemphigoid, but because side effects are common, particularly in the elderly, steroid-sparing agents such as azathioprine are often used. Mycophenolate mofetil has been suggested as an effective alternative. To test this alternative, researchers conducted a multicenter, controlled comparison of azathioprine and mycophenolate mofetil plus systemic corticosteroids for bullous pemphigoid.
They randomized 73 patients at 13 dermatology centers in Germany to receive either 2 mg/kg azathioprine and 0.5 mg/kg methylprednisolone or 2 g/day mycophenolate mofetil and 0.5 mg/kg methylprednisolone. Once blisters were no longer developing, the steroid dose was tapered. The mean fol…