Comment

In the study by Burton et al.13 there was no definition of "disease control" and little clinical data were available, although patients were followed up for 3 years. We noted that the decision to include patients in this trial was made by the consultant after prednisolone had been started to suppress new blisters. The plasma exchange trial15 excluded patients over 80 years of age. Low doses of prednisolone (0-3 mg/kg/day) were used in both treatment groups although, on average, higher doses were required to achieve disease control. With the current available evidence the value of combination treatment remains doubtful.

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