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

R Cascio Ingurgio1,2, A Alfano1,2, L Gargiulo1,2

  • 1Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.

The Australasian Journal of Dermatology
|May 27, 2025
PubMed
Summary
This summary is machine-generated.

Systemic corticosteroids provide rapid initial healing for pyoderma gangrenosum (PG), but biologic therapies demonstrate superior long-term effectiveness and sustained improvement in managing this challenging inflammatory skin disorder.

Keywords:
biologic therapycorticosteroidspyoderma gangrenosumre‐epithelialisationulcer healing

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Area of Science:

  • Dermatology
  • Immunology
  • Pharmacology

Background:

  • Pyoderma gangrenosum (PG) is a rare, severe, and often debilitating inflammatory skin disease.
  • Current treatments like corticosteroids have significant long-term risks, necessitating exploration of alternative therapies.
  • Biologic agents represent a promising avenue for managing PG due to their targeted mechanisms.

Purpose of the Study:

  • To compare the long-term efficacy of biologic therapies against systemic corticosteroids in patients with pyoderma gangrenosum.
  • To evaluate ulcer healing and re-epithelialization rates over an extended period.
  • To identify optimal treatment strategies for sustained PG management.

Main Methods:

  • Retrospective analysis of 15 pyoderma gangrenosum patients across two international centers.
  • Patients were categorized into two groups: biologic therapy (n=8) and systemic corticosteroids (n=7).
  • Ulcer healing outcomes were assessed at multiple time points: week 16, weeks 28-32, and week 54.

Main Results:

  • Systemic corticosteroids demonstrated faster initial ulcer reduction and re-epithelialization by week 16.
  • Patients treated with biologic therapies exhibited gradual but sustained improvement in ulcer healing over the long term.
  • Biologics showed a favorable trend for sustained disease control compared to corticosteroids.

Conclusions:

  • While corticosteroids offer rapid initial benefits for pyoderma gangrenosum, their long-term use is limited by potential adverse effects.
  • Biologic therapies demonstrate a gradual and sustained efficacy, establishing their significant therapeutic role in the long-term management of PG.
  • This study supports the consideration of biologic agents for achieving durable remission in pyoderma gangrenosum.