{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T03:05:36Z","timestamp":1790132736975,"version":"4.0.1"},"reference-count":51,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2023,12,22]],"date-time":"2023-12-22T00:00:00Z","timestamp":1703203200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001659","name":"German Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Care"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,4,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Pemphigus vulgaris (PV) and pemphigus foliaceus (PF) are potentially life-threatening autoimmune blistering diseases. Treatment is based on long-term immunosuppression with high doses of glucocorticosteroids in combination with potentially corticosteroid-sparing agents and\/or rituximab. Immunoadsorption (IA) has emerged as a fast-acting adjuvant treatment option.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To assess the clinical efficacy of IA in addition to best medical treatment (BMT).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a multicentre (26 centres from Germany and Austria) randomized controlled trial in 72 patients with newly diagnosed, relapsed or chronic active PV or PF (34 female patients and 38 male patients, aged 42\u201372\u2005years) comparing BMT (prednisolone 1.0\u2005mg kg\u22121 per day plus azathioprine or mycophenolate) with adjuvant IA (BMT + IA). Central 1 : 1 randomization was done at the coordinating centre for clinical trials (KKS Marburg). The primary endpoint was analysed using Kaplan\u2013Meier and Cox regression methods.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The study was ended prematurely owing to safety concerns after random allocation of 72 patients to BMT + IA (n = 34) or BMT (n = 38). The primary endpoint, time to complete remission on therapy, was not significantly different for the two groups [hazard ratio (HR) 1.35, 95% confidence interval (CI) 0.68\u20132.69; P = 0.39]. The cumulative dose of prednisolone was significantly lower in the BMT + IA group compared with BMT alone (difference \u22121214, 95% CI \u22122225 to \u221270; P = 0.03). In a post hoc analysis, patients with more extensive PV\/PF showed a tendency towards a shorter time to remission in the BMT + IA group compared with the BMT group (HR 1.87, P = 0.17 in patients with baseline Pemphigus Disease Area Index \u2265 15). While more adverse events were observed in patients in the BMT group (29 vs. 25), severe adverse events were more frequent in patients in the BMT + IA group (17 events in 10 patients vs. 11 events in 8 patients).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In this study, adjuvant IA did not demonstrate a shorter time to clinical remission, but a corticosteroid-sparing effect was observed. In patients with extensive PV\/PF, post hoc analysis suggests that adjuvant IA may lead to earlier remission, but potential adverse events must be carefully weighed against the expected benefits.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/bjd\/ljad489","type":"journal-article","created":{"date-parts":[[2023,12,22]],"date-time":"2023-12-22T14:50:24Z","timestamp":1703256624000},"page":"657-667","source":"Crossref","is-referenced-by-count":14,"title":["Efficacy and safety of adjuvant immunoadsorption in pemphigus vulgaris and pemphigus foliaceus (IA-Pem Study): a multicentre randomized controlled trial"],"prefix":"10.1093","volume":"190","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3265-0011","authenticated-orcid":false,"given":"Nina","family":"van Beek","sequence":"first","affiliation":[{"name":"Department of Dermatology, Allergology and Venereology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R\u00fcdiger","family":"Eming","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Reuss","sequence":"additional","affiliation":[{"name":"Coordinating Center for Clinical Trials, Phillips University , Marburg , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Detlef","family":"Zillikens","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Allergology and Venereology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikl\u00f3s","family":"S\u00e1rdy","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergy, University Hospital , LMU Munich, Munich , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4330-1861","authenticated-orcid":false,"given":"Claudia","family":"G\u00fcnther","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University Hospital Carl Gustav Carus , TU Dresden, Dresden , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitra","family":"Kiritsi","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology, University Hospital Freiburg , Freiburg , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandrine","family":"Benoit","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Allergology, University Hospital W\u00fcrzburg , W\u00fcrzburg , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Beissert","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University Hospital Carl Gustav Carus , TU Dresden, Dresden , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Regine","family":"Gl\u00e4ser","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Allergology, Christian-Albrechts University , Kiel , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harald","family":"Gollnick","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology, Otto-von-Guericke University , Magdeburg , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Orsolya N","family":"Horv\u00e1th","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergy, University Hospital , LMU Munich, Munich , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christiane","family":"Pfeiffer","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergology, University Hospital Ulm , Ulm , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"R\u00f6cken","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Eberhard Karls University , T\u00fcbingen , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franziska","family":"Schauer","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology, University Hospital Freiburg , Freiburg , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Schreml","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University Medical Centre Regensburg , Regensburg , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerstin","family":"Steinbrink","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Johannes-Gutenberg University Mainz , Mainz , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Zink","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergology, Technical University Munich , Munich , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Schade-Brittinger","sequence":"additional","affiliation":[{"name":"Coordinating Center for Clinical Trials, Phillips University , Marburg , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Hertl","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1206-8913","authenticated-orcid":false,"given":"Enno","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Allergology and Venereology"},{"name":"L\u00fcbeck Institute of Experimental Dermatology, University of L\u00fcbeck , L\u00fcbeck , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,12,22]]},"reference":[{"key":"2024041719051461200_ljad489-B1","doi-asserted-by":"crossref","first-page":"882","DOI":"10.1016\/S0140-6736(19)31778-7","article-title":"Pemphigus","volume":"394","author":"Schmidt","year":"2019","journal-title":"Lancet"},{"key":"2024041719051461200_ljad489-B2","first-page":"17026","article-title":"Pemphigus","volume-title":"Nat Rev Dis Primers","author":"Kasperkiewicz","year":"2017"},{"key":"2024041719051461200_ljad489-B3","doi-asserted-by":"crossref","first-page":"13804","DOI":"10.1074\/jbc.M611365200","article-title":"Desmoglein versus non-desmoglein signaling in pemphigus acantholysis: characterization of novel signaling pathways downstream of pemphigus vulgaris antigens","volume":"282","author":"Chernyavsky","year":"2007","journal-title":"J Biol 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