Biologic therapy for refractory pemphigoid gestationis: An evidence-based systematic review
Abstract
To the Editor: Pemphigoid gestationis (PG) is a rare inflammatory condition of pregnancy characterized by vesicobullous eruption and severe pruritus. It has been linked tomaternal and fetal complications. Although use of biologics for refractory PG remains novel, this systematic review summarizes evidence surrounding their use for this condition. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we searched Embase and MEDLINE databases using specific keywords (Supplementary Table I, available via Mendeley at https://doi.org/10.17632/hxhtnx5g7r.1). Quality of evidencewas assessed usingOxford Centre for Evidence-Based Medicine 2011 Levels of Evidence. After independent screening by 2 reviewers, 20 articles ( publication date: 1998-2023) reflecting 25 patients and 28 treatmentswere included (Fig 1; Supplemental Table II, available via Mendeley at https://doi.org/10.17632/hxhtnx5g7r.1). The mean age of mothers was 33.1 years (range: 17-44 years). The mean time-to-onset of patients with PG in the antepartum period was 5.2 months (24/25). PG continued into the postpartum period for 60% (15/ 25) of cases. There were PG episodes during previous pregnancies in 6 (24%) instances. All patients previously failed nonbiologic systemic therapy including systemic corticosteroids (100%) (Supplementary Table II). The mean treatment duration was 94.2 days (25/ 28). All patients used systemic concomitant medications of which prednisone/prednisolone was…
How strong is the evidence?
Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 25 participants or records.
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