Using Biologics to Reduce Long-Term Corticosteroid Use in Pyoderma Gangrenosum: Real-World Evidence From Two Centres

BackgroundPyoderma gangrenosum (PG) is a challenging inflammatory skin disorder. While corticosteroids offer a rapid response, their long-term risks necessitate alternative treatments.ObjectiveTo compare the long-term effectiveness of biologic therapies versus systemic corticosteroids in PG management.MethodsA retrospective analysis of 15 PG patients from two centres (Sydney, Australia, and Milan, Italy) was conducted. Patients received either biologic therapies (n = 8) or corticosteroids (n = 7), with ulcer healing outcomes assessed at weeks 16, 28-32 and 54.ResultsAt week 16, corticosteroids led to faster ulcer reduction and re-epithelialisation. However, biologic-treated patients showed sustained improvement over time, supporting their role in long-term PG management.ConclusionWhile corticosteroids provide an initial advantage, biologics demonstrate gradual and sustained efficacy, suggesting a long-term therapeutic role in PG treatment.