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Dexamethasone + cyclophosphamide, commonly administered as Dexamethasone Cyclophosphamide Pulse (DCP) therapy, is an intensive immunosuppressive regimen utilized for the management of severe autoimmune disorders, most notably pemphigus vulgaris. The treatment protocol typically involves the intermittent intravenous administration of high-dose dexamethasone (a potent glucocorticoid) combined with cyclophosphamide (an alkylating agent). Dexamethasone functions by binding to the glucocorticoid receptor, leading to the suppression of inflammatory cytokines and the modulation of the immune response. Cyclophosphamide acts as a prodrug that is metabolized into active mustard compounds which cross-link DNA, effectively inhibiting the proliferation of B and T lymphocytes responsible for the production of pathogenic autoantibodies. This combination therapy is designed to induce rapid clinical remission and minimize the side effects associated with prolonged, daily high-dose oral corticosteroid use. Clinical research conducted at institutions like the Jinnah Postgraduate Medical Centre has focused on comparing the efficacy and safety of this regimen against other steroid-sparing pulse therapies.
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