Risankizumab as a Therapeutic Approach for Recalcitrant Pyoderma Gangrenosum.

Pyoderma gangrenosum (PG) is a neutrophilic dermatosis that is challenging to diagnose and treat. Clinicians frequently use fast-acting corticosteroids, which are subsequently combined with slower-acting immunosuppressants to progressively taper the corticosteroid dosage. Current research is focused...

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Publicado en:Advances in Skin & Wound Care Vol. 37; no. 5; pp. 276 - 280
Autores principales: Michelucci, Alessandra, Manzo Margiotta, Flavia, Granieri, Giammarco, Salvia, Giorgia, Fidanzi, Cristian, Bevilacqua, Matteo, Panduri, Salvatore, Romanelli, Marco, Dini, Valentina
Formato: case study pictorial Journal Article
Publicado: Lippincott Williams & Wilkins May2024
Acceso en línea:Ver este registro en EBSCOhost
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      dt: May2024
      vid: 37
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      pub: Lippincott Williams & Wilkins
      place: Baltimore, Maryland
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        atl: Risankizumab as a Therapeutic Approach for Recalcitrant Pyoderma Gangrenosum.
      aug:
        au:
          Michelucci, Alessandra
          Manzo Margiotta, Flavia
          Granieri, Giammarco
          Salvia, Giorgia
          Fidanzi, Cristian
          Bevilacqua, Matteo
          Panduri, Salvatore
          Romanelli, Marco
          Dini, Valentina
        affil: Dermatology Resident, Department of Dermatology, University of Pisa, Italy
      sug:
        subj:
          Pyoderma Gangrenosum Drug Therapy
          Wounds, Chronic Drug Therapy
          Wounds, Chronic Therapy
          Pyoderma Gangrenosum Therapy
          Antibodies, Monoclonal Therapeutic Use
          Methylprednisolone Therapeutic Use
          Wound Care
          Female
          Adult
          Middle Age
          Pyoderma Gangrenosum Pathology
          Antibodies, Monoclonal Administration and Dosage
          Prednisone Administration and Dosage
          Drug Tapering
          Autolytic Debridement
          Adrenal Cortex Hormones Therapeutic Use
          Lidocaine Administration and Dosage
          Methylprednisolone Administration and Dosage
          Drugs, Off-Label
          Drug Therapy, Combination
          Treatment Outcomes
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Female
      ab: Pyoderma gangrenosum (PG) is a neutrophilic dermatosis that is challenging to diagnose and treat. Clinicians frequently use fast-acting corticosteroids, which are subsequently combined with slower-acting immunosuppressants to progressively taper the corticosteroid dosage. Current research is focused on the use of monoclonal antibodies (mAbs) directed against target molecules involved in the pathogenesis of PG. However, available data on their efficacy are based on sporadic case reports and clinical experiences, so the authors aimed to evaluate the efficacy of risankizumab, an anti-interleukin-23 mAb, in the management of two complex PG cases. The authors enrolled two patients with PG who were already treated with immunosuppressive therapies. Their management was based on the off-label use of an mAb directed against the p19 subunit of interleukin-23: risankizumab. Patients received subcutaneous injections of 150 mg at the start of treatment, at week 4, and then every 10 weeks thereafter. Systemic therapy was combined with local management of ulcers, based on the principles of TIME (tissue, infection, moisture balance, and epithelialization) applied to the inflammatory and noninflammatory phases of PG. Clinical resolution was obtained at week 24 for patient 1 and week 16 for patient 2 and was maintained until week 40, without adverse effects or disease recurrence. These clinical cases demonstrate that risankizumab is a valid tool in terms of efficacy and safety for complicated cases of multirefractory PG when provided in parallel with local personalized wound management.
      pubtype: Academic Journal
      doctype:
        case study
        pictorial
        Journal Article
      ougenre: Article
    language: English
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