Definitions and outcome measures for bullous pemphigoid: Recommendations by an international panel of experts - 18/02/12

Doi : 10.1016/j.jaad.2011.06.032

Dedee F. Murrell, MA, BMBCh, MD, FACD ^a,^⁎ , Benjamin S. Daniel, MBBS ^a, Pascal Joly, MD, PhD ^b, Luca Borradori, MD ^c, Masayuki Amagai, MD, PhD ^d, Takashi Hashimoto, MD, PhD ^e, Frédéric Caux, MD, PhD ^f, Branka Marinovic, MD, PhD ^g, Animesh A. Sinha, MD, PhD ^h, Michael Hertl, MD ⁱ, Philippe Bernard, MD, PhD ^ae, David Sirois, DMD, PhD ^j, Giuseppe Cianchini, MD ^k, Janet A. Fairley, MD ^m, Marcel F. Jonkman, MD, PhD ⁿ, Amit G. Pandya, MD ^o, David Rubenstein, MD, PhD ^p, Detlef Zillikens, MD ^q, Aimee S. Payne, MD, PhD ^s, David Woodley, MD ^r, Giovanna Zambruno, MD ^l, Valeria Aoki, MD, PhD ^t, Carlo Pincelli, MD ^u, Luis Diaz, MD ^p, Russell P. Hall, MD ^v, Michael Meurer, MD, PhD ^x, Jose M. Mascaro, MD ^y, Enno Schmidt, MD ^q, Hiroshi Shimizu, MD, PhD ^w, John Zone, MD ^z, Robert Swerlick, MD ^ac, Daniel Mimouni, MD ^ad, Donna Culton, MD ^p, Jasna Lipozencic, MD, PhD ^g, Benjamin Bince, MD ^aa, Sergei A. Grando, MD, PhD, DSc ^ag, Jean-Claude Bystryn, MD ^ab, Victoria P. Werth, MD ^s,^af
^a Department of Dermatology, St George Hospital, University of New South Wales, Sydney, Australia
^b Clinique Dermatologique, Institut National de la Santé et de la Recherche Médicale (INSERM), INSERM U905, Rouen University Hospital, Dermatology Department, Rouen University Hospital, University of Rouen, Rouen, France
^c Department of Dermatology, University Hospital of Bern, Bern, Switzerland
^d Keio University School of Medicine, Tokyo, Japan
^e Kurume University School of Medicine, Kurume, Japan
^f Department of Dermatology, University of Paris XIII, Bobigny, France
^g Department of Dermatology and Venereology, Zagreb University Hospital Center and School of Medicine, Zagreb, Croatia
^h Department of Dermatology, State University of New York at Buffalo, Buffalo, New York
ⁱ Department of Dermatology, University Hospital, Marburg, Germany
^j Department of Oral Medicine, New York University College of Dentistry, New York, New York
^k Immunodermatology Department, Instituto Dermopatico dell’Immacolata, Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS) IRCCS, Rome, Italy
^l Laboratory of Molecular and Cell Biology, Instituto Dermopatico dell’Immacolata, Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS) IRCCS, Rome, Italy
^m Department of Dermatology, University of Iowa and Department of Veterans Affairs Medical Center Iowa City, Iowa City, Iowa
ⁿ Department of Dermatology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
^o Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas
^p Department of Dermatology, University of North Carolina, Chapel Hill, North Carolina
^q Department of Dermatology, University of Luebeck, Luebeck, Germany
^r Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, California
^s Department of Dermatology, University of Pennsylvania, Philadelphia, Pennsylvania
^t Department of Dermatology, University of Sao Paulo, Sao Paulo, Brazil
^u Institute of Dermatology, School of Biosciences and Biotechnologies, University of Modena and Reggio Emilia, Modena, Italy
^v Division of Dermatology, Duke Medical Center, Durham, North Carolina
^w Department of Dermatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
^x Carl Gustav Carus Medical School, Dresden University of Technology, Dresden, Germany
^y Department of Dermatology, University of Barcelona, Barcelona, Spain
^z Department of Dermatology, University of Utah, Salt Lake City, Utah
^aa Department of Dermatology, Jose R. Reyes Memorial Medical Center, Manila, Philippines
^ab New York University Medical Center, New York, New York
^ac Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia
^ad Department of Dermatology, Rabin Medical Center, Beilinson Campus, Petach Tikva, Israel
^ae Department of Dermatology, Robert Debré University Hospital, Reims, France
^ag Department of Dermatology, Department of Biological Chemistry Cancer Center & Research Institute, Institute for Immunology, University of California, Irvine, California
^af Philadelphia Department of Veterans Affairs Medical Center, Philadelphia, Pennsylvania

Reprint requests: Dedee F. Murrell, MA, BMBCh, MD, FACD, Department of Dermatology, St George Hospital, University of New South Wales, Sydney, Australia.

Abstract

Our scientific knowledge of bullous pemphigoid (BP) has dramatically progressed in recent years. However, despite the availability of various therapeutic options for the treatment of inflammatory diseases, only a few multicenter controlled trials have helped to define effective therapies in BP. A major obstacle in sharing multicenter-based evidences for therapeutic efforts is the lack of generally accepted definitions for the clinical evaluation of patients with BP. Common terms and end points of BP are needed so that experts in the field can accurately measure and assess disease extent, activity, severity, and therapeutic response, and thus facilitate and advance clinical trials. These recommendations from the International Pemphigoid Committee represent 2 years of collaborative efforts to attain mutually acceptable common definitions for BP and proposes a disease extent score, the BP Disease Area Index. These items should assist in the development of consistent reporting of outcomes in future BP reports and studies.

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Key words : bullous pemphigoid, consensus, definitions, outcome measures, severity score

Abbreviations used : AAD, BP, BPDAI, DAI, PDAI

Plan

Intermediate end points

Late observation end points

Relapse/flare

Treatment failure

BP disease activity index

Discussion and conclusion

	The International Pemphigus and Pemphigoid Foundation generously supported renting rooms at the American Academy of Dermatology and audiovisual equipment; the European Society for Dermatological Research and European Academy of Dermatology provided meeting rooms. This report was supported in part by a grant from the National Institutes of Health (K24-AR 02207) to Dr Werth.
	Conflicts of interest: None declared.

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Vol 66 - N° 3

P. 479-485 - mars 2012 Retour au numéro

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Definitions and outcome measures for bullous pemphigoid: Recommendations by an international panel of experts - 18/02/12

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