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. 2025 May 27;66(5):305-308.
doi: 10.1111/ajd.14532. Online ahead of print.

Using Biologics to Reduce Long-Term Corticosteroid Use in Pyoderma Gangrenosum: Real-World Evidence From Two Centres

R Cascio Ingurgio  1   2 , A Alfano  1   2 , L Gargiulo  1   2 , L Ibba  1   2 , A Narcisi  1 , F Satgé  3   4 , M Stark  5   6 , A Costanzo  1   2 , D F Murrell  5   6
Affiliations

Using Biologics to Reduce Long-Term Corticosteroid Use in Pyoderma Gangrenosum: Real-World Evidence From Two Centres

R Cascio Ingurgio et al. Australas J Dermatol. .

Abstract

Background: Pyoderma gangrenosum (PG) is a challenging inflammatory skin disorder. While corticosteroids offer a rapid response, their long-term risks necessitate alternative treatments.

Objective: To compare the long-term effectiveness of biologic therapies versus systemic corticosteroids in PG management.

Methods: A retrospective analysis of 15 PG patients from two centres (Sydney, Australia, and Milan, Italy) was conducted. Patients received either biologic therapies (n = 8) or corticosteroids (n = 7), with ulcer healing outcomes assessed at weeks 16, 28-32 and 54.

Results: At week 16, corticosteroids led to faster ulcer reduction and re-epithelialisation. However, biologic-treated patients showed sustained improvement over time, supporting their role in long-term PG management.

Conclusion: While corticosteroids provide an initial advantage, biologics demonstrate gradual and sustained efficacy, suggesting a long-term therapeutic role in PG treatment.

Keywords: biologic therapy; corticosteroids; pyoderma gangrenosum; re‐epithelialisation; ulcer healing.

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Conflict of interest statement

L. Gargiulo has been a consultant and/or speaker and has participated to advisory boards for Abbvie, Almirall, Eli Lilly, Pfizer, Sanofi and UCB Pharma. L. Ibba has been a consultant for Almirall. A. Narcisi has served on advisory boards, received honoraria for lectures and research grants from Almirall, Abbvie, Leo Pharma, Celgene, Eli Lilly, Janssen, Novartis, Sanofi‐Genzyme, Amgen and Boehringer Ingelheim. A. Costanzo has served as an advisory board member, consultant and has received fees and speaker's honoraria or has participated in clinical trials for Abbvie, Almirall, Biogen, LEO Pharma, Lilly, Janssen, Novartis, Pfizer, Sanofi Genzyme and UCB‐Pharma. DF. Murrell is an author for UptoDate for BP, has scientific cooperations and advisory roles in the field of eczema and psoriasis with Sanofi, AbbVie, Arena, Attovia, BMS, UCB, Incyte, Leo, Lilly, Galderma, Dermira, Pfizer, BMS, Kineska, Fujisawa, Novartis and Evelo. In the area of blistering diseases, she has scientific cooperations and advisory roles with ArgenX, Sanofi Regeneron, Principia, Janssen, Lilly, Ono, Almirall, RAPT and Roche. She is creator of the ABQOL/TABQOL and co‐creator of the BPDAI. R. Cascio Ingurgio, A. Alfano, F. Satgé and M. Stark have nothing to declare.

Figures

FIGURE 1
FIGURE 1
Comparative re‐epithelialisation and ulcer size reduction in patients treated with systemic corticosteroids versus biologic/prior steroidal therapies for pyoderma gangrenosum (PG) at different time points (Week 16, Week 28–32 and Week 54). PG, pyoderma gangrenosum; W16, Week 16; W28‐32, Week 28–32; W54, Week 54; SD, standard deviation.
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