Effectiveness of systemic treatments for pyoderma gangrenosum: a systematic review of observational studies and clinical trials

The British Journal of Dermatology
A C R PartridgeP Fleming

Abstract

Pyoderma gangrenosum (PG) is a neutrophilic dermatosis with substantial morbidity. There is no consensus on gold-standard treatments. To review the effectiveness of systemic therapy for PG. We searched six databases for 24 systemic therapies for PG. Primary outcomes were complete healing and clinical improvement; secondary outcomes were time to healing and adverse effects. We found 3326 citations and 375 articles underwent full-text review; 41 studies met the inclusion criteria. There were 704 participants in 26 retrospective cohort studies, three prospective cohort studies, seven case series, one case-control study, two open-label trials and two randomized controlled trials (RCTs). Systemic corticosteroids were the most studied (32 studies), followed by ciclosporin (21 studies), biologics (16 studies) and oral dapsone (11 studies). One RCT (STOP-GAP, n = 121) showed that prednisolone and ciclosporin were similar: 15-20% of patients showed complete healing at 6 weeks and 47% at 6 months. Another RCT (n = 30) found that infliximab was superior to placebo at 2 weeks (46% vs. 6% response), with a 21% complete healing rate at 6 weeks. Two uncontrolled trials showed 60% and 37% healing within 4 months for canakinumab and infliximab,...Continue Reading

References

Dec 1, 1976·Archives of Dermatology·R N Shore
Mar 1, 1996·Journal of the American Academy of Dermatology·F C PowellH O Perry
Sep 23, 2000·JAMA : the Journal of the American Medical Association·A P HughesJ P Callen
Oct 11, 2002·Scandinavian Journal of Gastroenterology·T LjungP M Hellström
Aug 9, 2003·The American Journal of Gastroenterology·Miguel RegueiroGary R Lichtenstein
Jun 19, 2004·The Journal of Dermatological Treatment·D VidalA Alomar
Oct 12, 2004·Arthritis and Rheumatism·Angela EhlingUlf Müller-Ladner
Nov 10, 2004·International Journal of Dermatology·W P Daniel SuHarold O Perry
Jul 16, 2005·Journal of the American Academy of Dermatology·Jörg ReichrathWolfgang Tilgen
Jul 22, 2006·BMJ : British Medical Journal·Trevor BrooklynChris Probert
Apr 17, 2007·Orphanet Journal of Rare Diseases·Uwe Wollina
Jan 29, 2008·Journal of the American College of Surgeons·Lisa S PoritzWalter A Koltun
May 28, 2009·Journal of the European Academy of Dermatology and Venereology : JEADV·E RuoccoG Nicoletti
Jun 2, 2009·Journal of Cutaneous Medicine and Surgery·Vimal PrajapatiAlain Brassard
Mar 17, 2010·Journal of the American Academy of Dermatology·Jeremiah MillerSteven R Feldman
Apr 3, 2010·Der Hautarzt; Zeitschrift für Dermatologie, Venerologie, und verwandte Gebiete·L TrémezayguesJ Reichrath
Nov 13, 2010·Clinical and Experimental Dermatology·R M BhatS Furtado
Oct 20, 2011·BMJ : British Medical Journal·Julian P T HigginsUNKNOWN Cochrane Statistical Methods Group
Apr 27, 2012·The Journal of Investigative Dermatology·Sinéad M LanganMartin C Gulliford
Sep 11, 2012·Journal of Crohn's & Colitis·Xian-rui WuBo Shen
May 17, 2013·International Journal of Dermatology·Neide PereiraAmérido Figueiredo
Jul 6, 2013·Digestive Diseases and Sciences·F Argüelles-AriasJ M Herrerías-Gutiérrez
Oct 1, 2012·Advances in Wound Care·Heidi GoodarziEmanual Maverakis
Jun 14, 2015·BMJ : British Medical Journal·Anthony D OrmerodUNKNOWN UK Dermatology Clinical Trials Network’s STOP GAP Team
Aug 9, 2015·Journal of the American Academy of Dermatology·Sara F BraswellAlex G Ortega-Loayza
Oct 17, 2015·The British Journal of Dermatology·A G A KoliosL E French

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Citations

Sep 2, 2018·The British Journal of Dermatology·D N Dorrell, W W Huang
Aug 17, 2019·International Wound Journal·Cenk DemirdoverHaluk Vayvada
Dec 31, 2019·F1000Research·Josh FletcherAfsaneh Alavi
Apr 9, 2020·International Wound Journal·Birte BurgdorfJoachim Dissemond
Feb 11, 2021·Case Reports in Pathology·Yutaka TsutsumiMitsuhiro Tachibana
Aug 27, 2021·Clinical Practice and Cases in Emergency Medicine·Daniel Finnin

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