Treatment of pyoderma gangrenosum with mycophenolate mofetil as a steroid-sparing agent.

Abstract

BACKGROUND:

Mycophenolate mofetil (MMF) has enjoyed increasing popularity as an emerging immunosuppressant treatment for various autoimmune dermatologic conditions, including pyoderma gangrenosum (PG).

OBJECTIVE:

The aim of this study was to examine the efficacy and safety of MMF as used in PG.

METHODS:

A retrospective chart review was conducted for all patients with PG treated with MMF at our institution (Victoria, Australia) for the past 11 years (2001-2012).

RESULTS:

We identified 26 patients, 14 female and 12 male. Nine patients (34.6%) had associated systemic conditions. All patients received prednisolone. MMF was used as a first-line steroid-sparing agent in 11 patients (42.3%), second-line in 14 (53.8%), and third-line in 1 (3.85%). The average duration of treatment was 12.1 months. Fourteen patients experienced side effects (53.8%), although most were mild (26.9%). One patient died after a sigmoid colon perforation (3.85%). Overall 22 patients demonstrated clinical improvement during MMF treatment (84.6%). Thirteen patients achieved complete ulcer healing (50%), 10 while taking MMF and 3 after ceasing it.

LIMITATIONS:

This is a retrospective study based on a single-center cohort.

CONCLUSION:

Our experience suggests that MMF is highly efficacious in PG together with prednisolone, or as part of combination therapy with other immunosuppressants.

• Authors: Jane Li, Robert Kelly
• Journal: Journal of the American Academy of Dermatology (J Am Acad Dermatol) Vol. 69 Issue 4 Pg. 565-9 (Oct 2013) ISSN: 1097-6787 [Electronic] United States
• PMID: 23850090 (Publication Type: Comparative Study, Evaluation Study, Journal Article)
• Copyright: Copyright © 2013 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

Chemical References

• Anti-Inflammatory Agents, Non-Steroidal
• Mycophenolic Acid

Topics

• Adult
• Aged
• Aged, 80 and over
• Anti-Inflammatory Agents, Non-Steroidal (therapeutic use)
• Cohort Studies
• Dose-Response Relationship, Drug
• Drug Administration Schedule
• Female
• Follow-Up Studies
• Hospitalization (statistics & numerical data)
• Humans
• Male
• Middle Aged
• Mycophenolic Acid (adverse effects, analogs & derivatives, therapeutic use)
• Pyoderma Gangrenosum (diagnosis, drug therapy, epidemiology)
• Retrospective Studies
• Risk Assessment
• Severity of Illness Index
• Treatment Outcome
• Victoria
• Wound Healing (drug effects)
• Young Adult