Intravenous Immunoglobulin Therapy for Pyoderma Gangrenosum: A Multicenter Retrospective Analysis in 81 Patients: Intravenous Immunoglobulin Therapy for Pyoderma Gangrenosum: A Multicenter Retrospective Analysis: M. Ronicke et al.
Background: Pyoderma gangrenosum (PG) is rare neutrophil skin disease causing painful, progressively enlarging ulcers. Among the treatment options, intravenous immunoglobulin (IVIG) is a therapy of first choice for paraneoplastic PG. Otherwise, it is used in therapy-refractory courses. Objective: To...
| Publicado en: | American Journal of Clinical Dermatology Vol. 26; no. 1; pp. 139 - 147 |
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| Autores principales: | , , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Springer Nature
Jan2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=182304584&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 182304584 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 11750561 C4Q jtl: American Journal of Clinical Dermatology issn: 11750561 maglogo: N pubinfo: dt: Jan2025 vid: 26 iid: 1 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 182304584 180873002 182304584 182304584 10.1007/s40257-024-00904-w 182304584 ppf: 139 ppct: 8 formats: tig: atl: Intravenous Immunoglobulin Therapy for Pyoderma Gangrenosum: A Multicenter Retrospective Analysis in 81 Patients: Intravenous Immunoglobulin Therapy for Pyoderma Gangrenosum: A Multicenter Retrospective Analysis: M. Ronicke et al. aug: au: Ronicke, Moritz Sollfrank, Lukas Vitus, Martin V. Walter, Lukas J. Krieter, Manuel Moelleken, Maurice Dissemond, Joachim Schultz, Erwin Lauffer, Felix von den Driesch, Peter Erfurt-Berge, Cornelia affil: https://ror.org/00f7hpc57 Department of Dermatology, Uniklinikum Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Ulmenweg 18, 91054, Erlangen, Germany sug: subj: Immunoglobulins, Intravenous Therapeutic Use Pyoderma Gangrenosum Drug Efficacy Evaluation Patient Safety Steroids Therapeutic Use Methylprednisolone Therapeutic Use Immunoglobulins, Intravenous Administration and Dosage Immunoglobulins, Intravenous Adverse Effects Human Multicenter Studies Retrospective Design Record Review Germany Odds Ratio Confidence Intervals Adverse Drug Event Descriptive Statistics Male Female Adult Middle Age Aged Aged, 80 and Over Funding Source Treatment Outcomes Drug Therapy, Combination Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Aged, 80 & over Male Female ab: Background: Pyoderma gangrenosum (PG) is rare neutrophil skin disease causing painful, progressively enlarging ulcers. Among the treatment options, intravenous immunoglobulin (IVIG) is a therapy of first choice for paraneoplastic PG. Otherwise, it is used in therapy-refractory courses. Objective: To assess the efficacy and safety of IVIG therapy in patients with PG. Methods: A retrospective chart review for patients in five dermatologic wound centres in Germany was performed. Results: Overall, 81 patients were included. IVIG was used as adjunct therapy with (methyl-) prednisolone and/or a steroid sparing therapy in 77 (95.1%) cases. Response to treatment (combined complete and partial, defined as tendency to heal and cessation of lesion progression, respectively) was 49.3% 1 month after initiation of IVIG. In total 18.8% had a complete response after 6 months. Statistically significantly higher response rates were observed in patients with diabetes mellitus and thyroid disease [odds ratio (OR) 3.49, confidence interval (CI) 1.13–10.80 and OR 6.64, CI 1.01–43.57, respectively]. Patients with solid malignancy tended to have better response (OR 4.36, CI 0.79–23.91). A higher IVIG dose was also associated with a tendency towards better response rates (OR 2.70, CI 0.84–8.63). In total, 1 (1.2%) severe adverse event (myocardial infarction with consequent death) was observed as well as three moderate adverse events, with two thromboembolic events (2.5%) and one acute kidney injury (1.2%). Other adverse events were mild or unlikely to be associated with IVIG therapy, with 14 events in 10 patients overall (12.3%). Conclusions: This multicentre retrospective study shows the important role of adjunctive IVIG therapy in patients with PG with recalcitrant courses. Identifying subgroups with a higher probability of response could improve future response rates and save patients from ineffective treatment and potential adverse events. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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