Using Biologics to Reduce Long-Term Corticosteroid Use in Pyoderma Gangrenosum: Real-World Evidence From Two Centres

Pyoderma gangrenosum (PG) is a challenging inflammatory skin disorder. While corticosteroids offer a rapid response, their long-term risks necessitate alternative treatments.

To compare the long-term effectiveness of biologic therapies versus systemic corticosteroids in PG management.

A retrospective analysis of 15 PG patients from two centres (Sydney, Australia, and Milan, Italy) was conducted. Patients received either biologic therapies (n = 8) or corticosteroids (n = 7), with ulcer healing outcomes assessed at weeks 16, 28-32 and 54.

At week 16, corticosteroids led to faster ulcer reduction and re-epithelialisation. However, biologic-treated patients showed sustained improvement over time, supporting their role in long-term PG management.

While corticosteroids provide an initial advantage, biologics demonstrate gradual and sustained efficacy, suggesting a long-term therapeutic role in PG treatment.