In generalized cases, bullous pemphigoid (BP) requires treatment with oral systemic corticosteroids, l mg/kg per day, prednisone or prednisolone. Despite oral steroids, BP is not controlled in about 30% of patients treated with prednisolone metasulfobenzoate (PO-MS), 1 mg/kg per day.1,2 Prednisolone is the active molecule accounting for the anti-inflammatory activity in vivo after oral intake of prednisone or PO-MS. Some cases of clinical resistance in patients treated for inflammatory diseases have been observed following the administration of PO-MS, which were reversed using prednisone in the same mole-per-liter dose. Pharmacokinetic studies in healthy subjects showed higher availability of prednisolone after administration of prednisone than after PO-MS because of better intestinal absorption of prednisone.3-5 The aim of this retrospective study was to determine if prednisone if more efficacious than PO-MS for the initial control of BP.
Lebrun-Vignes B, Roujeau J, Bernard P, et al. Prednisone Is More Effective Than Prednisolone Metasulfobenzoate in the Treatment of Bullous Pemphigoid. Arch Dermatol. 1999;135(1):89–90. doi:10-1001/pubs.Arch Dermatol.-ISSN-0003-987x-135-1-dlt0199
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