Onset of Pyoderma Gangrenosum in Patients on Biologic Therapies: A Systematic Review.

OBJECTIVE: To summarize clinical outcomes of paradoxical pyoderma gangrenosum (PG) onset in patients on biologic therapy. METHODS: The authors conducted MEDLINE and EMBASE searches using PRISMA guidelines to include 57 patients (23 reports). RESULTS: Of the included patients, 71.9% (n = 41/57) noted...

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Publicado en:Advances in Skin & Wound Care Vol. 35; no. 8; pp. 454 - 461
Autores principales: Lytvyn, Yuliya, Mufti, Asfandyar, Maliyar, Khalad, Sachdeva, Muskaan, Yeung, Jensen
Formato: research systematic review tables/charts Journal Article
Publicado: Lippincott Williams & Wilkins Aug2022
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Aug2022
      vid: 35
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      pub: Lippincott Williams & Wilkins
      place: Baltimore, Maryland
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        10.1097/01.ASW.0000820252.96869.8e
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        atl: Onset of Pyoderma Gangrenosum in Patients on Biologic Therapies: A Systematic Review.
      aug:
        au:
          Lytvyn, Yuliya
          Mufti, Asfandyar
          Maliyar, Khalad
          Sachdeva, Muskaan
          Yeung, Jensen
        affil: At the University of Toronto, Ontario, Canada, Yuliya Lytvyn, PhD is Medical Student, Temerty Faculty of Medicine
      sug:
        subj:
          Inflammation Drug Therapy
          Biological Therapy Adverse Effects
          Pyoderma Gangrenosum Risk Factors
          Risk Assessment
          Human
          Systematic Review
          Medline
          Embase
          Rituximab
          Tumor Necrosis Factor
          Immunoglobulins Administration and Dosage
          Administration, Intravenous
          Adrenal Cortex Hormones Administration and Dosage
          Administration, Oral
          Antibiotics Administration and Dosage
          Interleukins
          Cyclosporine
          Male
          Female
          Canada
          Ontario
          Male
          Female
      ab: OBJECTIVE: To summarize clinical outcomes of paradoxical pyoderma gangrenosum (PG) onset in patients on biologic therapy. METHODS: The authors conducted MEDLINE and EMBASE searches using PRISMA guidelines to include 57 patients (23 reports). RESULTS: Of the included patients, 71.9% (n = 41/57) noted PG onset after initiating rituximab, 21.1% (n = 12/57) noted tumor necrosis factor α (TNF-α) inhibitors, 5.3% (n = 3/57) reported interleukin 17A inhibitors, and 1.8% (n = 1/57) reported cytotoxic T-lymphocyte-associated protein 4 antibodies. The majority of patients (94.3%) discontinued biologic use. The most common medications used to resolve rituximab-associated PG were intravenous immunoglobulins, oral corticosteroids, and antibiotics, with an average resolution time of 3.3 months. Complete resolution of PG in TNF-α-associated cases occurred within an average of 2.2 months after switching to another TNF-α inhibitor (n = 1), an interleukin 12/23 inhibitor (n = 2), or treatment with systemic corticosteroids and cyclosporine (n = 3), systemic corticosteroids alone (n = 1), or cyclosporine alone (n = 1). CONCLUSIONS: Further investigations are warranted to determine whether PG onset is associated with underlying comorbidities, the use of biologic agents, or a synergistic effect. Nevertheless, PG may develop in patients on rituximab or TNF-α inhibitors, suggesting the need to monitor and treat such adverse effects.
      pubtype: Academic Journal
      doctype:
        research
        systematic review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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