Treatment of pyoderma gangrenosum with mycophenolate mofetil as a steroid-sparing agent.

Background: Mycophenolate mofetil (MMF) has enjoyed increasing popularity as an emerging immunosuppressant treatment for various autoimmune dermatologic conditions, including pyoderma gangrenosum (PG).Objective: The aim of this study was to examine the efficacy and safety of MMF as used in PG.Method...

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Publicado en:Journal of the American Academy of Dermatology Vol. 69; no. 4; pp. 565 - 570
Autores principales: Li, Jane, Kelly, Robert
Formato: research Journal Article
Publicado: Elsevier B.V. Oct2013
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Oct2013
      vid: 69
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      pub: Elsevier B.V.
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        atl: Treatment of pyoderma gangrenosum with mycophenolate mofetil as a steroid-sparing agent.
      aug:
        au:
          Li, Jane
          Kelly, Robert
        affil: Department of Dermatology, St Vincent's Hospital Melbourne, Victoria, Australia. Electronic address: jane.melb@gmail.com.
      sug:
        subj:
          Antiinflammatory Agents, Non-Steroidal Therapeutic Use
          Mycophenolic Acid
          Pyoderma Gangrenosum Diagnosis
          Pyoderma Gangrenosum Drug Therapy
          Wound Healing Drug Effects
          Adult
          Aged
          Aged, 80 and Over
          Prospective Studies
          Dose-Response Relationship, Drug
          Drug Administration Schedule
          Female
          Hospitalization Statistics and Numerical Data
          Human
          Male
          Middle Age
          Mycophenolic Acid Adverse Effects
          Mycophenolic Acid Therapeutic Use
          Pyoderma Gangrenosum Epidemiology
          Retrospective Design
          Risk Assessment
          Severity of Illness Indices
          Treatment Outcomes
          Victoria
          Young Adult
          Adult: 19-44 years
          Aged: 65+ years
          Aged, 80 & over
          Middle Aged: 45-64 years
          Female
          Male
      ab: Background: Mycophenolate mofetil (MMF) has enjoyed increasing popularity as an emerging immunosuppressant treatment for various autoimmune dermatologic conditions, including pyoderma gangrenosum (PG).Objective: The aim of this study was to examine the efficacy and safety of MMF as used in PG.Methods: A retrospective chart review was conducted for all patients with PG treated with MMF at our institution (Victoria, Australia) for the past 11 years (2001-2012).Results: We identified 26 patients, 14 female and 12 male. Nine patients (34.6%) had associated systemic conditions. All patients received prednisolone. MMF was used as a first-line steroid-sparing agent in 11 patients (42.3%), second-line in 14 (53.8%), and third-line in 1 (3.85%). The average duration of treatment was 12.1 months. Fourteen patients experienced side effects (53.8%), although most were mild (26.9%). One patient died after a sigmoid colon perforation (3.85%). Overall 22 patients demonstrated clinical improvement during MMF treatment (84.6%). Thirteen patients achieved complete ulcer healing (50%), 10 while taking MMF and 3 after ceasing it.Limitations: This is a retrospective study based on a single-center cohort.Conclusion: Our experience suggests that MMF is highly efficacious in PG together with prednisolone, or as part of combination therapy with other immunosuppressants.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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