A randomised controlled trial to compare the safety, effectiveness and cost effectiveness of doxycycline (200 mg/day) with oral prednisolone (0.5 mg/kg/day) for initial treatment of bullous pemphigoid: the Bullous Pemphigoid Steroids and Tetracyclines (BLISTER) Trial

Chalmers J R, Wojnarowska F, Kirtschig G, Mason J, Childs M, Whitham D, Harman K, Chapman A, Walton S, Schmidt E, Godec T R, Nunn A J & Williams H C
Record ID 32010000386
English
Authors' objectives: To evaluate the effectiveness, safety and cost-effectiveness of a strategy of initiating bullous pemphigoid (BP) treatment with oral doxycycline or oral prednisolone. We hypothesised that starting treatment with doxycycline gives acceptable short-term blister control while conferring long-term safety advantages over starting treatment with oral prednisolone. Bullous pemphigoid is an autoimmune blistering skin disorder with increased morbidity and mortality in the elderly.
Authors' recommendations: A strategy of starting BP patients on doxycycline is non-inferior to standard treatment with oral prednisolone for short-term blister control and considerably safer in the long term. The limitations of the trial were the wide non-inferiority margin, the moderate dropout rate and that serious adverse event collection was unblinded. Future work might include inducing remission with topical or oral corticosteroids and then randomising to doxycycline or prednisolone for maintenance.
Details
Project Status: Completed
URL for project: http://www.nets.nihr.ac.uk/projects/hta/0640351
Year Published: 2017
URL for published report: https://www.journalslibrary.nihr.ac.uk/hta/hta21100/#/abstract
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: England, United Kingdom
MeSH Terms
  • Prednisolone
  • Randomized Controlled Trials as Topic
  • Doxycycline
  • Pemphigoid, Bullous
Contact
Organisation Name: NIHR Health Technology Assessment programme
Contact Address: NIHR Journals Library, National Institute for Health and Care Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK
Contact Name: journals.library@nihr.ac.uk
Contact Email: journals.library@nihr.ac.uk
Copyright: <p>2010 Queen's Printer and Controller of HMSO</p>
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