糖皮质激素对类风湿关节炎患者难治性坏疽性脓皮病的阿达木单抗节约效应：病例系列

Glucocorticoid sparing effect on adalimumab for refractory pyoderma gangrenosum in patients with rheumatoid arthritis: A case series.

作者信息

Ohmura Shin-Ichiro, Morishita Naomi, Yonezawa Haruka, Yukishima Toshitaka, Ohkubo Yusuke

机构信息

Department of Rheumatology, Seirei Hamamatsu General Hospital, Hamamatsu, Shizuoka, Japan.

Department of Dermatology, Seirei Hamamatsu General Hospital, Hamamatsu, Shizuoka, Japan.

出版信息

Mod Rheumatol Case Rep. 2025 Jul 25;9(2):1-5. doi: 10.1093/mrcr/rxae075.

DOI:10.1093/mrcr/rxae075

PMID:39657705

Abstract

Pyoderma gangrenosum (PG) is a rare chronic skin disease characterized by painful skin ulcers. There are no treatment guidelines for PG; however, systemic treatment is often administered. Recently, adalimumab (ADA), a fully human monoclonal antibody against tumour necrosis factor, was approved for the treatment of refractory PG in Japan. However, data are limited, and it is not clear whether ADA has the same effect on the treatment of PG in patients with systemic rheumatic disease (SRD), including rheumatoid arthritis (RA). In addition, the glucocorticoid-sparing effect of ADA in SRD patients with PG has not yet been clarified. Herein, we present two successful cases of RA with glucocorticoid-refractory PG on ADA treatment. Our report suggests that ADA may have a glucocorticoid-sparing effect on refractory PG in patients with RA.

摘要

坏疽性脓皮病（PG）是一种罕见的慢性皮肤病，其特征为疼痛性皮肤溃疡。目前尚无PG的治疗指南；然而，通常会进行全身治疗。最近，阿达木单抗（ADA），一种抗肿瘤坏死因子的全人单克隆抗体，在日本被批准用于治疗难治性PG。然而，数据有限，尚不清楚ADA对包括类风湿关节炎（RA）在内的系统性风湿性疾病（SRD）患者的PG治疗是否具有相同效果。此外，ADA在患有PG的SRD患者中的糖皮质激素节省作用尚未阐明。在此，我们报告两例使用ADA治疗糖皮质激素难治性PG的RA成功病例。我们的报告表明，ADA可能对RA患者的难治性PG具有糖皮质激素节省作用。