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

Therapy of pyoderma gangrenosum in Germany: results of a survey among wound experts

“…Data obtained in the present study confirms that, nearly ten years after publication of this study, systemic regimens predominantly used in Germany continue to consist of prednisolone and/or cyclosporine as agents of first choice. Especially in treatment‐refractory cases, alternative therapeutic approaches combining systemic corticosteroids with mycophenolate mofetil and also treatment with tacrolimus, cyclophosphamide, or plasmapheresis have been repeatedly discussed in the past . However, it should be noted that biologic agents were hardly available during the period in question.…”

“…“Classic” immune modulators ▹Corticosteroids ▹Cyclosporine ▹Cyclophosphamide ▹Azathioprine ▹Mycophenolate mofetil ▹Methotrexate ▹Dapsone ▹Sulfasalazine + dapsone …”

Therapie des Pyoderma gangraenosum in Deutschland: Resultate einer Befragung von Experten

“…Die aktuell erhobenen Daten der hier vorliegenden Studie belegen, dass in Deutschland auch fast zehn Jahre nach der Veröffentlichung dieser Studie die vorwiegend eingesetzten systemischen Medikamente‐Regime weiterhin aus Prednisolon und/oder Ciclosporin als Mittel der ersten Wahl bestehen. Insbesondere bei therapierefraktären Verläufen wurden in der Vergangenheit wiederholt alternative Therapieansätze mittels der kombinierten Gabe von systemischen Glukokortikoiden mit Mycophenolatmofetil aber auch Therapien mit Tacrolimus, Cyclophosphamid oder Plasmapherese diskutiert . Hierbei ist jedoch zu beachten, dass in dem betrachteten Zeitraum Biologika, im Vergleich zu unserer aktuell vorliegenden Studie, kaum verfügbar waren und somit bei den Auswertungen nicht berücksichtigt werden konnten .…”

Mycophenolic acid in dermatology a century after its discovery

“…A recent Australian retrospective case series included 26 patients with pyoderma gangrenosum using MMF and concomitant prednisolone, of whom 85% demonstrated clinical improvement and 50% (13 participants) achieved complete regression . Another smaller Australian study showed similar results, with 46% of patients with neutrophilic dermatosis (eight with pyoderma gangrenosum) achieving complete remission on MMF …”

“…Most research published involves case reports and series. Recalcitrant pyoderma gangrenosum has shown to respond well to MMF alone or in combination with other agents including dapsone, CSA and prednisolone …”