Treatment of refractory IgA vasculitis with dapsone: a systematic review
Open Access
- 1 May 2020
- journal article
- review article
- Published by Korean Pediatric Society in Clinical and Experimental Pediatrics
- Vol. 63 (5), 158-163
- https://doi.org/10.3345/kjp.2019.00514
Abstract
IgA vasculitis, formerly known as Henoch-Schonlein purpura, is a systemic IgA-mediated vasculitis of the small vessels commonly seen in children. The natural history of IgA vasculitis is generally self-limiting; however, one-third of patients experience symptom recurrence and a refractory course. This systematic review examined the use of dapsone in refractory IgA vasculitis cases. A literature search of PubMed databases retrieved 13 articles published until June 14, 2018. The most common clinical feature was a palpable rash (100% of patients), followed by joint pain (69.2%). Treatment response within 1-2 days was observed in 6 of 26 patients (23.1%) versus within 3-7 days in 17 patients (65.4%). Relapse after treatment discontinuation was reported in 17 patients (65.4%) but not in 3 pati-ents (11.5 %). Four of the 26 patients (15.4%) reported ad-verse effects of dapsone including arthralgia (7.7%), rash (7.7%), and dapsone hypersensitivity syndrome (3.8%). Our findings suggest that dapsone may affect refractory IgA vasculitis. Multi-center randomized placebo-controlled trials are necessary to determine the standard dosage of dapsone at initial or tapering of treatment in IgA vasculitis patients and evaluate whether dapsone has a significant benefit versus steroids or other medi-cations.Keywords
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