Pyoderma gangrenosum is a chronic ulcerating skin condition that often occurs in association with inflammatory bowel disease (IBD).
There have been a number of reports of Pyoderma gangrenosum responding to infliximab, a monoclonal antibody against tumor necrosis factor.
Dr Brooklyn and colleagues from England conducted the first randomized placebo controlled trial of any drug for the treatment of Pyoderma gangrenosum.
The research team studied the role of infliximab in this disorder.
Patients 18 years of age or older with a clinical diagnosis of Pyoderma gangrenosum were invited to take part.
The team randomized 30 patients to receive an infusion of infliximab at 5 mg/kg or placebo at week 0.
Patients were then assessed at week 2, and non-responders were offered open labelled infliximab.
The researchers' primary end point was clinical improvement at week 2, with secondary end points being remission and improvement at week 6.
After randomization, 13 patients received infliximab, and 17 patients received placebo.
|46% in the infliximab group improved vs 6% in the placebo group|
The team found that at week 2, 46% of patients in the infliximab group had improved compared with 6% in the placebo group.
The research team noted that this difference was significant.
Overall, 29 patients received infliximab with 69% demonstrating a beneficial clinical response.
The team observed that the remission rate at week 6 was 21%.
There was no response in 31% of patients.
Dr Brooklyn's team concluded, “This study has demonstrated that infliximab at a dose of 5 mg/kg is superior to placebo in the treatment of Pyoderma gangrenosum.”
“Open label treatment with infliximab also produced promising results.”
“Infliximab treatment should be considered in patients with Pyoderma gangrenosum.”