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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
Appears in following Topics:
Pyoderma Gangrenosum - Treatment