{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T06:11:08Z","timestamp":1778911868907,"version":"3.51.4"},"reference-count":31,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,5,10]],"date-time":"2026-05-10T00:00:00Z","timestamp":1778371200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,10]],"date-time":"2026-05-10T00:00:00Z","timestamp":1778371200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Deutsche Derma Gesell"],"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and objective<\/jats:title>\n                    <jats:p>Pemphigus treatment has seen significant advancements, yet long\u2010term remission remains a challenge. Comparative data on the long\u2010term effectiveness of available therapies are limited. We compared 10\u2010year relapse rates in pemphigus patients treated with azathioprine or cyclophosphamide plus high\u2010dose IV corticosteroids<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and methods<\/jats:title>\n                    <jats:p>In this retrospective single\u2010center cohort study, we analyzed 91 patients with pemphigus vulgaris\/foliaceus treated between 1985 and 2022. 43 patients received oral azathioprine, 48 received intermittent intravenous and oral cyclophosphamide. All patients also received intermittent high\u2010dose IV corticosteroids for \u2265\u00a01\u00a0year. As rituximab became widely available only after 2019, follow\u2010up was insufficient to include it in this analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Remission occurred equally quickly in both groups, but patients treated with cyclophosphamide suffered from significantly fewer relapses: 27% of cyclophosphamide patients had \u2265\u00a01 relapse vs. 80.6% with azathioprine (p\u00a0&lt;\u00a00.001). 70% of cyclophosphamide patients remained relapse\u2010free and were off therapy for an average of 7\u00a0years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Aggressive initial immunosuppressive therapy with cyclophosphamide is associated with a significantly lower long\u2010term relapse rate in pemphigus. While routine use is limited by its toxicity, these findings underscore the potential for durable remission and the importance of long\u2010term disease control as a treatment goal.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ddg.70171","type":"journal-article","created":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T05:53:14Z","timestamp":1778478794000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cyclophosphamide is associated with long\u2010term treatment\u2010free remission in patients with pemphigus"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8711-5190","authenticated-orcid":false,"given":"Bettina","family":"Santler","sequence":"first","affiliation":[{"name":"Department of Dermatology University Hospital Muenster  Muenster 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