Pyoderma Gangrenosum in a Patient with Crohn's Disease Treated with Adalimumab: A Case-Based Review and Systematic Review of the Current LiteratureFousekis, Mpakogiannis, Karampinis
et alClin Pract (2025) 15 (3)
Abstract: Background: Pyoderma gangrenosum (PG) is a rare inflammatory cutaneous disorder that frequently occurs in association with systemic diseases such as inflammatory bowel disease (IBD). This case report describes a 23-year-old female with Crohn's disease (CD) who developed PG and was successfully treated with adalimumab. The objective of this study is to present the clinical course, treatment approach, and outcomes while reviewing the existing literature on the efficacy of adalimumab in PG management. Methods: A case report is presented, detailing clinical presentation, diagnostic evaluation, and treatment strategy. Additionally, a systematic review was conducted using PubMed to assess studies on adalimumab in PG, focusing on treatment response, remission rates, and adverse effects. Results: The patient presented with ulcerative lesions on her lower extremities and sacroiliitis. After corticosteroid therapy, adalimumab was initiated, leading to significant ulcer healing, reduced back pain, and CD remission. The systematic review identified seven studies on adalimumab in PG. Findings suggest that adalimumab is effective in steroid-refractory cases, with remission achieved in a significant proportion of patients. The most common adverse effects were infections, but overall, adalimumab showed a favorable safety profile. Conclusions: This case highlights the importance of early diagnosis and multidisciplinary management of PG in CD patients. Adalimumab appears to be a promising therapeutic option, particularly for steroid-resistant PG, though further research is needed to establish standardized treatment protocols.
Biological Disease-Modifying Antirheumatic Drugs Decrease Uric Acid Levels in the Sera of Patients with Psoriatic ArthritisPerković, Petrić, Maleš
et alCurr Issues Mol Biol (2025) 47 (3)
Abstract: There are many explanations for increased levels of serum uric acid (SUA) in patients with psoriatic arthritis (PsA), but correlation with different treatment options in PsA is not well elucidated. Our aim was to determine the effects of biological disease-modifying antirheumatic drugs (bDMARDs) on SUA levels in patients with PsA.We analyzed the data of PsA patients treated with different bDMARDs from January 2007 to June 2021. Patients treated with interleukin-17 (IL-17) inhibitors (secukinumab and ixekizumab) and tumor necrosis factor α (TNFα) inhibitors (golimumab, infliximab, adalimumab, certolizumab pegol, and etanercept) were included.A total of 87 patients were included. The SUA levels decreased in 60 (69%) patients after a 3-6-month-long follow-up, and in 25 (28.7%), we noticed an increase. The average decrease in SUA levels was 9.4 ± 49.5 µmol/L (p = 0.039); for TNFα patients, it was 7.3 ± 59.8 µmol/L (p = 0.386), and for IL-17 patients, it was 12.6 ± 28.4 µmol/L (p = 0.013). The levels of SUA decreased in 81.8% of patients treated with infliximab, as well as in 76% of those treated with secukinumab and in 72.7% of those treated with etanercept. The largest average decrease in SUA levels was recorded in the group treated with golimumab (23 µmol/L).A significant decrease in SUA levels was noticed, especially in patients treated with IL-17 inhibitors. Further studies should identify which bDMARD is the most potent in the lowering of SUA levels. bDMARDs were efficient in PsA disease activity.
Comparative real-world effectiveness of ustekinumab versus anti-TNF in Crohn's disease: 12-month maintenance phase results from the prospective, observational RUN-CD study using propensity score adjustmentBokemeyer, Plachta-Danielzik, Gilman
et alJ Crohns Colitis (2025)
Abstract: The prospective RUN-CD registry investigates the effectiveness of ustekinumab (UST) and other biologics in Crohn's disease (CD) across Germany. Based on data from the registry, this study presents the maintenance phase results of a 12-month real-world-evidence (RWE) comparison of CD patients initiating new biologic therapies with UST or anti-TNF.After excluding patients using biologics other than UST and anti-TNF and those with missing outcomes, the final sample consisted of 618 CD patients. Clinical remission (CR), defined as a Harvey-Bradshaw Index (HBI) ≤4, was the prespecified endpoint at 12 months. Switching to another biologic therapy was considered an outcome failure. Propensity score (PS) adjustment was used to reduce the effect of confounders.The study included 343 CD patients treated with UST and 264 treated with anti-TNF. Over 12 months, the frequency of therapy switches was significantly higher for infliximab (28%) compared to UST (17%) and adalimumab (17%) (p=0.045). There was no significant difference in CR rates at 12 months between the UST and anti-TNF groups (65.8% vs. 60.0%, p=0.262). However, in week-16 responders, CR rates at 12 months were significantly higher with UST (77.6%) versus anti-TNF (65.4%) (p=0.041). The change in EQ-VAS (QoL) scores between UST and anti-TNF showed a 5.1-point difference favouring UST (p=0.002).In this 12-month RWE comparison, overall CR rates were similar between UST and anti-TNF. However, among week-16 responders, CR rates were significantly higher with UST. Additionally, UST was associated with a significantly greater improvement in QoL compared to anti-TNF.© The Author(s) 2025. Published by Oxford University Press on behalf of European Crohn’s and Colitis Organisation. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.
Efficacy of High Dose Adalimumab for the Management of Hidradenitis Suppurativa: A Systematic ReviewJones, Sun, Kennedy
Australas J Dermatol (2025)
Abstract: Adalimumab, a tumour necrosis factor-alpha inhibitor, has demonstrated efficacy in managing hidradenitis suppurativa (HS) at the standard dose of 40 mg weekly; however, many patients do not achieve adequate clinical response with this regimen. This systematic review aimed to evaluate the efficacy and safety of 80 mg weekly adalimumab in HS management. Four studies, with a total of 67 patients, were reviewed. The studies reported improvements in HS disease severity and quality of life measures with the use of high-dose adalimumab. Adverse events were infrequent and generally mild, with no severe adverse events reported. The findings suggest a favourable response to high-dose adalimumab for patients with severe or refractory HS; however, definitive conclusions are limited by the scarcity and low quality of the available data. Further high-quality research with standardised outcome measures and longer follow-up are needed to validate the role of dose intensification in HS management.© 2025 Australasian College of Dermatologists.
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