Dermatology · 2 h ago
Fewer Than Half of Patients With Multisite MMP Achieved Complete Remission
In a retrospective single-center cohort of 77 patients with multisite mucous membrane pemphigoid, 45% achieved simultaneous complete remission across all affected sites. Oral and ocular disease often persisted or relapsed, limiting overall remission.
- 45% achieved remission at all affected sites.
- Oral and ocular disease often limited multisite remission.
- Relapse occurred in 44% of patients with site-level remission.
- Treatment associations do not establish comparative efficacy.
Researchers reviewed records of 77 patients with immunopathology-confirmed multisite mucous membrane pemphigoid treated at a tertiary referral center between 2013 and 2025. Patients had disease at two or more anatomic sites and at least 12 months of post-treatment follow-up. The primary outcome was complete remission at all involved sites, regardless of therapy. Most patients (68; 88%) had high-risk disease; oral involvement was present in 73 (95%) and ocular involvement in 51 (66%).
Thirty-five patients (45%) achieved multisite complete remission, after a median of 32 months. Although 64 patients (83%) reached complete remission at one or more sites, persistent oral and ocular disease commonly prevented remission across all sites. Among those who achieved remission at one or more sites, 28 of 64 (44%) later relapsed; oral and ocular mucosa were involved in 18 (64%) and 14 (50%) of these relapses, respectively. Rituximab-based regimens and Janus kinase inhibitor therapy were associated with high rates of improvement, while serious adverse events were most frequent with cyclophosphamide monotherapy and Janus kinase inhibitor therapy.
The findings highlight the difference between site-level and whole-patient remission. Interpretation is limited by the retrospective design and single-center cohort; treatment associations do not establish comparative efficacy or safety.
In practice
For clinicians managing multisite mucous membrane pemphigoid, the cohort suggests that remission at one site should not be assumed to represent control across all involved sites: fewer than half of patients achieved simultaneous remission, and oral and ocular disease frequently persisted or relapsed. These findings support assessing disease activity by anatomic site and tracking overall multisite remission. The study was retrospective and single-center; reported treatment-response associations do not establish which regimen is most effective or safest and do not justify treatment changes on their own.
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JAMA Dermatology: Site-Specific Treatment and Remission Patterns in Multisite Mucous Membrane Pemphigoid ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.