Herberger K, Dissemond J, Brüggestrat S, Sorbe C, Augustin M, et al.
Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatol.... Date of publication 2019 Jan 1;volume 17(1):32-41.
1. J Dtsch Dermatol Ges. 2019 Jan;17(1):32-41. doi: 10.1111/ddg.13741. Epub 2018 Dec
28.
Biologics and immunoglobulins in the treatment of pyoderma gangrenosum - analysis
of 52 patients.
Herberger K(1), Dissemond J(2), Brüggestrat S(1), Sorbe C(1), Augustin M(1).
Author information:
(1)Center of Competence for Health Care Research in Dermatology (CVderm),
Institute for Health Care Research in Dermatology and Nursing (IVDP),
Hamburg-Eppendorf University Medical Center, Hamburg, Germany.
(2)Department of Dermatology, Essen University Medical Center, Essen, Germany.
BACKGROUND AND OBJECTIVES: Corticosteroids and cyclosporine A are frequently
ineffective as first-line therapies in the treatment of pyoderma gangrenosum (PG)
and associated with a number of adverse effects. The objective of the present
study was to analyze the effectiveness and safety of biologics and intravenous
immunoglobulins (IVIGs).
PATIENTS AND METHODS: Retrospective, dual-center cohort study analyzing the
treatment outcome in patients with PG who received biologics and IVIGs.
RESULTS: Fifty-two patients (mean age: 58.4 years) with 75 wound episodes (mean
wound size: 53.2 cm²) were included in the study. Overall, 92.3 % of patients
initially received corticosteroids (CSs; 48/52); 51.9 % cyclosporine A (CSA;
27/52). In 275 therapeutic attempts, complete remission or improvement were
achieved in 63.6 % (21/33) of patients on infliximab; 57.1 % (16/28) on
adalimumab; 71.4 % (5/7) on etanercept; 66.6 % (6/9) on ustekinumab and 66.7 %
(10/15) of patients who were given IVIGs. That figure was 48.8 % (38/78) for
those treated with CSs and 20.0 % (7/35) for individuals on CSA. On average,
adverse events occurred in 18.5 % (15/81) of cases treated with biologics in 20 %
(3/15) of patients receiving IVIGs, in 40 % (14/35) of individuals on CSA and in
10.4 % of those treated with CSs (5/48).
CONCLUSIONS: The present retrospective analysis suggests that both biologics -
especially TNFα antagonists - and IVIGs are well-tolerated and safe options in
the treatment of PG. Data from prospective comparative studies would be highly
desirable.
© 2018 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley &
Sons Ltd.
DOI: 10.1111/ddg.13741
PMID: 30592563
