Qualifying criteria have been expanded to Moderate to severe disease diagnosed by a Qualifying Criteria Moderate to severe CP/MMP disease with require diagnostic confirmation and appropriate dermatologist; involvement of multiple sites, oesophageal disease sites required for to severe ‘moderate involvement alone or conjunctiva alone. disease’. (A) AND AND Criteria are consistent with original version with details defined. (A) Corticosteroids or immunosuppressive Persistent disease despite standard E.g. immunosuppressant therapeutics that need agents are contraindicated; corticosteroid and treatment with at least to have been tried include: two immunosuppressant agents or B cell Corticosteroids OR depletion therapy (Rituximab) Azathioprine Cyclophosphamide Condition is unresponsive to OR Methotrexate Mycophenolate corticosteroids and immunosuppressive Severe side effects prohibit the continuation Rituximab agents; of corticosteroids and immunosuppressive agents unless corticosteroids or Severe side effects of immunosuppressant OR immunosuppressant agents are therapy include: contraindicated. Significant infection including sepsis Presenting with severe side effects of Malignancy Marrow suppression and cytopenia therapy. Unstable Diabetes Severe osteoporosis History of avascular necrosis Initial review to confirm response is unchanged, Response demonstrated at review at six Review Criteria Review is required every six months by a however, ongoing six monthly review has been trial months. Improvement to be Dermatologist or Opthalmologist with specific criteria defined for ongoing treatment. demonstrated for continuation of Response must be demonstrated at the initial (A) review at six months and improvement must supply. Consideration is now given to trial off therapy once be demonstrated for continuation of supply. disease is stable and/or reduce Ig dose. Disease recurrence or relapse and Consideration should be given to a trial-off duration of clinical remission. immunoglobulin (Ig) therapy once the patient has achieved stabilised disease or clinical
Qualifying Criteria Moderate to severe disease diagnosed by a dermatologist; AND Corticosteroids or immunosuppressive agents are contraindicated; OR Condition is unresponsive to corticosteroids and immunosuppressive agents; OR Presenting with severe side effects of therapy. Moderate to severe CP/MMP disease with involvement of multiple sites, oesophageal involvement alone or conjunctiva alone. AND Persistent disease despite standard corticosteroid and treatment with at least two immunosuppressant agents or B cell depletion therapy (Rituximab) OR Severe side effects prohibit the continuation of corticosteroids and immunosuppressive agents unless corticosteroids or immunosuppressant agents are contraindicated. Qualifying criteria have been expanded to require diagnostic confirmation and appropriate disease sites required for ‘moderate to severe disease’. (A) Criteria are consistent with original version with details defined. (A) E.g. immunosuppressant therapeutics that need to have been tried include: Corticosteroids Azathioprine Cyclophosphamide Methotrexate Mycophenolate Rituximab Severe side effects of immunosuppressant therapy include: Significant infection including sepsis Malignancy Marrow suppression and cytopenia Unstable Diabetes Severe osteoporosis History of avascular necrosis Review Criteria Response demonstrated at review at six months. Improvement to be demonstrated for continuation of supply. Disease recurrence or relapse and duration of clinical remission. Review is required every six months by a Dermatologist or Opthalmologist Response must be demonstrated at the initial review at six months and improvement must be demonstrated for continuation of supply. Consideration should be given to a trial-off immunoglobulin (Ig) therapy once the patient has achieved stabilised disease or clinical trial Initial review to confirm response is unchanged, however, ongoing six monthly review has been with specific criteria defined for ongoing treatment. (A) Consideration is now given to trial off therapy once disease is stable and/or reduce Ig dose.
cicatricial-pemphigoid%28cp%29-or-mucous-membrane-pemphigoid%28mmp%29.DOCX