Etanercept for the treatment of refractory pyoderma gangrenosum: A brief series

Background: Pyoderma gangrenosum (PG) is a rare ulcerative inflammatory condition of unknown etiology. Therapy for PG involves local wound care along with topical and systemic anti-inflammatory and other immunodulatory agents. Etanercept is one such immunomodulator with activity against the inflammatory cytokine, tumor necrosis factor. Objective: To evaluate the efficacy and safety of etanercept in the treatment of PG ulcers. Methods: A retrospective analysis was performed on seven patients with 11 refractory PG ulcers treated with subcutaneous injections of etanercept (25-50 mg twice weekly). Results: All seven patients with PG responded well to etanercept. Eight of the 11 ulcers (73%) completely healed with the mean time of (12.5 weeks), while the other three ulcers had marked reduction in size (within 8-18 weeks). Etanercept was well tolerated. No serious side-effects were reported. Only one patient discontinued the drug secondary to side-effects. Conclusion: Etanercept is an alternative treatment option for patients with refractory ulcers due to PG.