Successful treatment of etanercept- and adalimumab-resistant pyoderma gangrenosum with spesolimab, moderate-dose corticosteroids, and minocycline
Purpose Pyoderma gangrenosum (PG) is a rare, neutrophilic dermatosis characterized by rapidly developing, painful ulcers. This study explores the potential of spesolimab, an anti-IL-36R antibody, as a therapeutic option for refractory PG.Materials and methods We report a case of a 48-year-old male w...
Saved in:
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Taylor & Francis Group
2025-12-01
|
| Series: | Journal of Dermatological Treatment |
| Subjects: | |
| Online Access: | https://www.tandfonline.com/doi/10.1080/09546634.2025.2451811 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832594214906494976 |
|---|---|
| author | Hanlin Zhang Chao Wu Hongzhong Jin |
| author_facet | Hanlin Zhang Chao Wu Hongzhong Jin |
| author_sort | Hanlin Zhang |
| collection | DOAJ |
| description | Purpose Pyoderma gangrenosum (PG) is a rare, neutrophilic dermatosis characterized by rapidly developing, painful ulcers. This study explores the potential of spesolimab, an anti-IL-36R antibody, as a therapeutic option for refractory PG.Materials and methods We report a case of a 48-year-old male with refractory PG who failed to respond to etanercept and adalimumab. Upon admission, the patient presented with extensive, painful ulcerations on the trunk and extremities. He was started on oral methylprednisolone (32 mg/day) and minocycline (50 mg twice daily). After a week, minimal improvement was observed. After reviewing the screening results and discussing treatment options, the patient received two doses of spesolimab (900 mg intravenously) administered two weeks apart.Results Marked clinical improvement was observed after spesolimab initiation. Complete ulcer healing was achieved within six weeks of starting spesolimab, with no adverse effects reported.Conclusions This case demonstrates the potential efficacy of spesolimab for treating refractory PG, particularly in patients unresponsive to TNF-α inhibitors. Despite the added complexity of the patient’s underlying HBV infection and elevated M-protein, no HBV reactivation or other hematologic complications occurred. Further studies are needed to validate its role in managing PG and other neutrophilic dermatoses. |
| format | Article |
| id | doaj-art-6b672a936c394be19128f16eb5ea2d45 |
| institution | Kabale University |
| issn | 0954-6634 1471-1753 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Journal of Dermatological Treatment |
| spelling | doaj-art-6b672a936c394be19128f16eb5ea2d452025-01-20T01:10:18ZengTaylor & Francis GroupJournal of Dermatological Treatment0954-66341471-17532025-12-0136110.1080/09546634.2025.2451811Successful treatment of etanercept- and adalimumab-resistant pyoderma gangrenosum with spesolimab, moderate-dose corticosteroids, and minocyclineHanlin Zhang0Chao Wu1Hongzhong Jin2Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaPurpose Pyoderma gangrenosum (PG) is a rare, neutrophilic dermatosis characterized by rapidly developing, painful ulcers. This study explores the potential of spesolimab, an anti-IL-36R antibody, as a therapeutic option for refractory PG.Materials and methods We report a case of a 48-year-old male with refractory PG who failed to respond to etanercept and adalimumab. Upon admission, the patient presented with extensive, painful ulcerations on the trunk and extremities. He was started on oral methylprednisolone (32 mg/day) and minocycline (50 mg twice daily). After a week, minimal improvement was observed. After reviewing the screening results and discussing treatment options, the patient received two doses of spesolimab (900 mg intravenously) administered two weeks apart.Results Marked clinical improvement was observed after spesolimab initiation. Complete ulcer healing was achieved within six weeks of starting spesolimab, with no adverse effects reported.Conclusions This case demonstrates the potential efficacy of spesolimab for treating refractory PG, particularly in patients unresponsive to TNF-α inhibitors. Despite the added complexity of the patient’s underlying HBV infection and elevated M-protein, no HBV reactivation or other hematologic complications occurred. Further studies are needed to validate its role in managing PG and other neutrophilic dermatoses.https://www.tandfonline.com/doi/10.1080/09546634.2025.2451811Pyoderma gangrenosumspesolimabneutrophilic dermatosisbiologics |
| spellingShingle | Hanlin Zhang Chao Wu Hongzhong Jin Successful treatment of etanercept- and adalimumab-resistant pyoderma gangrenosum with spesolimab, moderate-dose corticosteroids, and minocycline Journal of Dermatological Treatment Pyoderma gangrenosum spesolimab neutrophilic dermatosis biologics |
| title | Successful treatment of etanercept- and adalimumab-resistant pyoderma gangrenosum with spesolimab, moderate-dose corticosteroids, and minocycline |
| title_full | Successful treatment of etanercept- and adalimumab-resistant pyoderma gangrenosum with spesolimab, moderate-dose corticosteroids, and minocycline |
| title_fullStr | Successful treatment of etanercept- and adalimumab-resistant pyoderma gangrenosum with spesolimab, moderate-dose corticosteroids, and minocycline |
| title_full_unstemmed | Successful treatment of etanercept- and adalimumab-resistant pyoderma gangrenosum with spesolimab, moderate-dose corticosteroids, and minocycline |
| title_short | Successful treatment of etanercept- and adalimumab-resistant pyoderma gangrenosum with spesolimab, moderate-dose corticosteroids, and minocycline |
| title_sort | successful treatment of etanercept and adalimumab resistant pyoderma gangrenosum with spesolimab moderate dose corticosteroids and minocycline |
| topic | Pyoderma gangrenosum spesolimab neutrophilic dermatosis biologics |
| url | https://www.tandfonline.com/doi/10.1080/09546634.2025.2451811 |
| work_keys_str_mv | AT hanlinzhang successfultreatmentofetanerceptandadalimumabresistantpyodermagangrenosumwithspesolimabmoderatedosecorticosteroidsandminocycline AT chaowu successfultreatmentofetanerceptandadalimumabresistantpyodermagangrenosumwithspesolimabmoderatedosecorticosteroidsandminocycline AT hongzhongjin successfultreatmentofetanerceptandadalimumabresistantpyodermagangrenosumwithspesolimabmoderatedosecorticosteroidsandminocycline |