Intravenous immunoglobulin is effective as a sole immunomodulatory agent in pyoderma gangrenosum unresponsive to systemic corticosteroids

Suchak, R.; Macedo, Camila; Glover, Matthew; Lawlor, Frances

doi:10.1111/j.1365-2230.2006.02275.x

Cited by 7 publications

(4 citation statements)

References 4 publications

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“…We report the successful treatment of PG with IVIg in a patient with refractory disease, limited treatment options due to multiple co‐morbidities, and serious complications of long‐term corticosteroid treatment. There are only nine other reports (25 patients in total) in the literature of IVIg used successfully in patients with PG, 5–13 and one report showing lack of efficacy in this disease 14 . As with our patient, in all of these cases the disease was longstanding and refractory to or unsuitable for other treatments.…”

Section: Discussionsupporting

confidence: 62%

“…Doses of 0.5 g/kg/day or 1 g/kg/day for 2 days, or 0.4 g/kg/day for 5 days have been reported, with the number of monthly treatments ranging from two to six. In one report the treatment was given successfully every 2 months over 10 cycles 11 . In our case the patient lived far from the hospital and after no adverse effects from the first infusion, the decision to treat over a shorter interval was largely for practical reasons.…”

Section: Discussionmentioning

confidence: 65%

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Treatment of refractory pyoderma gangrenosum with intravenous immunoglobulin

Zwaan¹,

Iland

Damian

2009

Aust J Dermatology

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We report a patient with pyoderma gangrenosum successfully treated with intravenous immunoglobulin. He had previously been treated for 4 years with high-dose corticosteroids and had developed insulin-dependent diabetes mellitus. Multiple corticosteroid-sparing agents had failed or were contraindicated. He developed no adverse effects from intravenous immunoglobulin, which allowed reduction of his prednisone to 3 mg/day, and his ulcer has completely healed.

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Section: Discussionsupporting

confidence: 62%

Section: Discussionmentioning

confidence: 65%

Treatment of refractory pyoderma gangrenosum with intravenous immunoglobulin

Zwaan¹,

Iland

Damian

2009

Aust J Dermatology

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“…In contrast, we used much lower doses of IVIG (0·5 g kg −1 body weight per day over two or three consecutive days) in patients with PG. Even this lower dose resulted in rapid improvement of skin lesions in our patients and in other cases with PG that have been reported in the literature 5–8 . Facing the very high costs of IVIG therapy, future studies using different dosages of IVIG for the treatment of PG are warranted in order to evaluate the optimal dose from a clinical as well as economic point of view.…”

Section: Clinical Data Of the Patients With Pg Treated With Intravenmentioning

confidence: 55%

Intravenous immunoglobulin for pyoderma gangrenosum

et al. 2008

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“…Our literature search yielded 26 articles, which describe 43 cases of PG treated with IVIG (see Fig. and Table S1; see Supporting Information) . The retrospective review identified six patients with PG treated with IVIG at our institutions.…”

Section: Resultsmentioning

confidence: 99%

Intravenous immunoglobulin as adjunct therapy for refractory pyoderma gangrenosum: systematic review of cases and case series

2018

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Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis. Treatment regimens for refractory cases are nonstandardized. Intravenous immunoglobulin (IVIG) is an emerging treatment with reported success, but the efficacy of IVIG for PG is unknown. In this systematic review of cases and case series, we assessed the efficacy of IVIG for the treatment of PG, as observed at our institution and reported in the literature. A retrospective chart review at two tertiary care hospitals between 2000 and 2015, and literature searches in PubMed/MEDLINE, EMBASE and Web of Science from all years were conducted. In total, there were 49 patients, including 43 patients from 26 articles and six institutional cases. There was complete or partial response in 43 (88%) patients and complete response in 26 (53%) patients. The mean time to initial response to treatment and treatment length were 3·5 (SD 3·3) weeks and 5·9 (SD 7·8) months, respectively. On average, 2·6 treatments had been trialled before IVIG initiation. IVIG was administered with systemic steroids in 43 (88%) cases. Mild adverse events, especially nausea and headache, were reported in 12 (24·5%) patients. Our systematic review suggests a potential role for IVIG as adjuvant therapy for refractory PG. Prospective clinical trials testing the efficacy of IVIG for refractory PG are needed to validate these findings.

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Intravenous immunoglobulin is effective as a sole immunomodulatory agent in pyoderma gangrenosum unresponsive to systemic corticosteroids

Cited by 7 publications

References 4 publications

Treatment of refractory pyoderma gangrenosum with intravenous immunoglobulin

Treatment of refractory pyoderma gangrenosum with intravenous immunoglobulin

Intravenous immunoglobulin for pyoderma gangrenosum

Intravenous immunoglobulin as adjunct therapy for refractory pyoderma gangrenosum: systematic review of cases and case series

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