Beissert 2007.

Study characteristics
Methods	Multicentre study in Germany; central randomisation; not masked Two parallel groups; initial dose was maintained until blister formation ceased and re‐epithelialisation started. Corticosteroid dose was then reduced every 2 weeks. After discontinuation of corticosteroid, azathioprine, or mycophenolate mofetil (MMF) dose was maintained for 4 more weeks, then reduced (see taper regimen on page 1537 of study report). Follow‐up of 720 days
Participants	73 participants with bullous pemphigoid, confirmed by direct and indirect immunofluorescence on salt split skin Mean age in the azathioprine group was 76 years (12 males, 26 females), and in the MMF group 75 years (15 males, 20 females). Disease severity was variable, mild to severe. Inclusion criteria Clinical lesions suggestive of BP Subepidermal blistering on histologic analysis of skin biopsy specimens Linear deposition of IgG and C3 along the dermoepidermal junction Deposition of autoantibodies at the blister roof on split‐skin analysis Exclusion criteria Treatment with oral or topical corticosteroids and other immunosuppressive drugs during the previous 4 weeks
Interventions	A) 38/38 oral methylprednisolone 0.5 mg/kg/day plus azathioprine sodium 2 mg/kg/day B) 35/35 oral methylprednisolone 0.5 mg/kg/day plus mycophenolate mofetil 2000 mg/day (tapering described on page 1537 of study report).
Outcomes	Primary Complete healing (complete re‐epithelialisation of all lesions) Cumulative steroid dose (until end of documentation > 720 days) (Table 11) Secondary Duration of remission (disease‐free interval) Safety profiles
Notes	Registered trial: NCT00431119 Cumulative corticosteroid dose: described as primary outcome until complete healing was achieved (page 1537); on page 1539, the cumulative corticosteroid dose was defined as corticosteroid dose until the end of the documentation period (> 720 days) (Table 11, Table 14). We presumed that calculated cumulative corticosteroid dose was calculated until the end of the documentation period. This trial was supported by an unrestricted grant from Hoffmann‐La Roche AG, producers and providers of the mycophenolate mofetil (CellCept) used in the study.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Quote: "Randomisation was stratified according to the clinical centre and performed centrally with the use of random number of three for each stratum" (Page 1537).
Allocation concealment (selection bias)	Unclear risk	Allocation concealment is not well described.
Blinding of participants and personnel (performance bias) All outcomes	High risk	Study design: "non blinded clinical trial" (Page 1448).
Blinding of outcome assessment (detection bias) All outcomes	High risk	Outcome assessors were not masked. Quote: "Since complete healing was a primary outcome measure, blinding was not considered necessary" (Page 1537).
Incomplete outcome data (attrition bias) All outcomes	Low risk	Yes: 1 participant was lost, 2 died of non‐treatment‐related causes ‐ they were included in the intention‐to‐treat analysis. The same number of participants who started the trial were analysed at the end of the trial. (Figure 1, page 1538)
Selective reporting (reporting bias)	Low risk	Outcomes reported for both outcome measures. Primary: complete healing Secondary: cumulative corticosteroid doses used
Other bias	Unclear risk	‐