Treatment of Pyoderma Gangrenosum With Cyclosporine

Matis, Wendy L.; Ellis, Charles N.; Griffiths, Christopher E.M.; Lazarus, Gerald S.

doi:10.1001/archderm.1992.01680180054005

Cited by 121 publications

(48 citation statements)

References 25 publications

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“…Despite published reports of particularly high response rates when treated with ciclosporin, [734][735][736][737] the RCT reported here has provided a robust demonstration that ciclosporin monotherapy is not superior to PYODERMA GANGRENOSUM WORK PROGRAMME NIHR Journals Library www.journalslibrary.nihr.ac.uk prednisolone in promoting healing in PG. Clinicians can use this information to guide their treatment choice, which may, as a result, become more dependent on issues of safety and tolerability as well as cost.…”

Section: Implications For Clinical Practicecontrasting

confidence: 54%

“…740 Nonetheless, prior to the design of this trial, various studies had reported high proportions of patients with PG achieving complete responses with ciclosporin treatment [734][735][736][737] which lead the STOP GAP trial to test the hypothesis that ciclosporin was superior to prednisolone for the treatment of PG. However, the study revealed no difference between the two treatments across a range of efficacy outcomes and there were narrow CIs around those lack of differences, suggesting that the study was large enough to exclude clinically important differences that might have been missed.…”

Section: Discussionmentioning

confidence: 99%

“…In the absence of guidelines, treatment decisions for cases of PG may be based on indirect comparisons of data between studies; any level of discrepancy in the designs intervention, control and outcomes can make such comparisons inappropriate. Small studies of ciclosporin for the treatment of PG have reported high proportions of patients achieving complete response, [734][735][736][737] but no direct comparison has been performed between this and the other commonly used systemic treatmentprednisolone. By comparing these two drugs in a RCT setting, we have generated robust, head-to-head data disproving the hypothesis that ciclosporin is superior to prednisolone for the treatment of PG.…”

Section: Discussionmentioning

confidence: 99%

“…734,735 Complete response was reported for all participants in a study of five patients receiving 4-5 mg/kg/day of oral ciclosporin 734 and 11 patients receiving the drug at an initial concentration of 4 mg/kg/day intravenously. 735 Other case series have reported encouraging proportions of patients, with a range of underlying diseases, achieving complete responses to ciclosporin (10 out of 11 736 and 3 out of 7 737 ). Vidal et al 738 and Vidal and Alomar 739 performed a review of 26 cases of classical PG.…”

Section: Introductionmentioning

confidence: 97%

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A programme of research to set priorities and reduce uncertainties for the prevention and treatment of skin disease

Kim

Batchelor

Bath‐Hextall

et al. 2016

Programme Grants Appl Res

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Programme Grants for Applied ResearchISSN 2050-4322 (Print) ISSN 2050-4330 (Online) This journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/).Editorial contact: nihredit@southampton.ac.ukThe full PGfAR archive is freely available to view online at www.journalslibrary.nihr.ac.uk/pgfar. Print-on-demand copies can be purchased from the report pages of the NIHR Journals Library website: www.journalslibrary.nihr.ac.uk Criteria for inclusion in the Programme Grants for Applied Research journalReports are published in Programme Grants for Applied Research (PGfAR) if (1) they have resulted from work for the PGfAR programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors. Programme Grants for Applied Research programmeThe Programme Grants for Applied Research (PGfAR) programme, part of the National Institute for Health Research (NIHR), was set up in 2006 to produce independent research findings that will have practical application for the benefit of patients and the NHS in the relatively near future. The Programme is managed by the NIHR Central Commissioning Facility (CCF) with strategic input from the Programme Director.The programme is a national response mode funding scheme that aims to provide evidence to improve health outcomes in England through promotion of health, prevention of ill health, and optimal disease management (including safety and quality), with particular emphasis on conditions causing significant disease burden.For more information about the PGfAR programme please visit the website: http://www.nihr.ac.uk/funding/programme-grants-forapplied-research.htm This reportThe research reported in this issue of the journal was funded by PGfAR as project number RP-PG-0407-10177. The contractual start date was in September 2008. The final report began editorial review in April 2014 and was accepted for publication in April 2016. As the funder, the PGfAR programme agreed the research questions and study designs in advance with the investigators. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The PGfAR editors and production house have tried to ensure the accuracy of the authors' report and would like to thank the reviewers for their constructive comments on the final report document. However, they do not accept liability for damages or losses arising from material published in this report.This report presents independent research funded by the National Institute for Health Research (NIHR). The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NHS, the NIHR, CCF, NETSCC, PGfAR or the Department of Health. If there are verbatim quotations included in this publication the views and opinions expressed by the interviewees are those of the interviewees and do not necessarily reflect those of the authors, those of the NHS, the NIHR, ...

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Section: Implications For Clinical Practicecontrasting

confidence: 54%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 97%

See 2 more Smart Citations

A programme of research to set priorities and reduce uncertainties for the prevention and treatment of skin disease

Kim

Batchelor

Bath‐Hextall

et al. 2016

Programme Grants Appl Res

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show abstract

“…Cylosporine has shown to be the most promising agent especially in severe recalcitrant cases of PG. [23][24][25][26][27][28][29] In addition, long-term maintenance therapy may be required in some patients because of persistent and recurrent nature of the disease.…”

Section: -814-17mentioning

confidence: 99%