Prednisone vs cyclosporine for pyoderma gangrenosum

What is known

• A randomized trial of 108 PG patients showed prednisone and cyclosporine had a similar healing rate of about 50% at 6 months. ¹
• Infection was more frequent in the prednisone group than the cyclosporine group in that trial. ¹
• Guidance describes oral corticosteroids as first-line for moderate-to-severe PG, with cyclosporine as an alternative for corticosteroid contraindications or treatment failure. ¹

What is unknown / caveats

• The only comparative trial reports outcomes at 6 months, not 12 weeks
• The trial healing endpoint is not stratified by moderate-to-severe severity in these excerpts
• Remaining evidence is uncontrolled case reports and cohorts, not comparative
• The excerpts describe the trial only secondhand and do not give a 12-week timepoint, so the exact comparison you ask about is not directly established here.

References

1. Martinelli VF, Martinelli Barbosa P, Dantas de Oliveira LS, de Melo LALV, Casa Nova JM, de Brito CAA. Atypical Forms of Pyoderma Gangrenosum in Inflammatory Bowel Disease: Report of Four Cases and Literature Review. Int Med Case Rep J. 2022;15:449-456. PMID: 36051090.

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Draft, generated by the IBDology RAG and not yet clinician-reviewed. Answers are grounded in the retrieved literature listed above; a high faithfulness score means the answer matches its sources, not that the sources are correct.