Current guidelines recommend that the disease severity and treatment efficacy should be evaluated with clinical scores in pemphigus/pemphigoid. PDAI in pemphigus and BPDAI in pemphigoid are widely used to determine whether additional second-line therapies (e.g., plasma change) should be considered if initial treatment is insufficient for disease control. To validate the utility of monitoring PDAI/BPDAI transitions, we retrospectively analysed 67 pemphigus and 47 pemphigoid patients who received the initial therapy in the dermatology department of an institute in Japan. We analysed PDAI/BPDAI score ratios of day7/ day0 and day14/ day0. In comparison between the groups of patients who needed additional therapies (Group B) or not (Group A), the ratios of day7/ day 0 were significantly decreased in Group A compared to Group B: 0.548 vs 0.761 in PDAI, 0.565 vs 0.901 in BPDAI (erosion/blister: E/B), 0.350 vs 0.760 in BPDAI (urticaria/erythema: U/E), respectively (p<0.05). The PDAI and BPDAI (E/B) ratios of day14/ day0 were also significantly reduced in Group A compared to Group B, (0.250 vs 0.621 and 0.172 vs 0.607, respectively, p<0.05). We focused the analysis on severe cases because there was no significant difference in PDAI/BPDAI scores between Group A and B before the initial treatments. The PDAI, BPDAI (E/B) and BPDAI (U/E) ratios of day 7/day0 significantly reduced in Group A compared to Group B (0.556 vs. 0.781, 0.661 vs.0.907 and 0.268 vs. 0.820, respectively, p<0.05). The PDAI and BPDAI (E/B) ratios of day14/ day0 were also significantly reduced in Group A compared to Group B (0.222 vs 0.641 and 0.256 vs 0.642, respectively, p<0.01). Our results indicate that PDAI/BPDAI transitions are possible early predictors for necessity of additional therapy during the initial treatment phase.

ESDR064 - Early Clinical Score Changes Predict Additional Treatment Necessity In Pemphigus/Pemphigoid

The scientific meeting of the European Society for Dermatological Research (ESDR) is held yearly, usually in September. With an international attendance of more than 1000 skin scientists from around the globe, the four-day event includes short oral presentations from peer-reviewed abstracts, keynote lectures from international experts, sponsored symposia, satellite programs, educational events as well as an important focus on posters, networking and building collaborations amongst scientists. For more information about this year’s meeting visit our website.