ITEM CRITERIA v2.1 PROPOSED REVISIONS TO THE CRITERIA SPECIALIST WORKING GROUP RATIONALE FOR ADDITIONS/CLARIFICATIONS Pyoderma Gangrenosum Pyoderma Gangrenosum Unchanged Condition Name Specialty Immunology Immunology Unchanged Unchanged Category Exceptional circumstances only Exceptional circumstances only Pyoderma Gangrenosum Specific Conditions Level of Insufficient data (). Insufficient data (Category 4a) Unchanged Evidence Justification Ig therapy is regarded as adjuvant treatment and is considered This section has been drafted for Evidence third or fourth line treatment, after alternative therapies have following assessment of the literature Category been unsuccessful in achieving improvement or remission. While Ig and consultation with the Australian has been proven to be effective in small case series (Patel et al, College of Dermatologists. 2015 and Cummins et al, 2007) and case reports (Cafardi et al, 2014 and De Zwaan et al, 2009), ideally it is used to enhance the effect of existing treatment, rather than as monotherapy. Indication Severe PG when immunosuppressant and biologic therapy is Two indications have been defined; either ineffective or inappropriate due to unacceptable side the second to support effects. recommencement of Ig therapy in responding patients that may relapse once treatment has been ceased. Relapse of PG in previously responding patients following a trial off Ig therapy
ITEM CRITERIA v2.1 PROPOSED REVISIONS TO THE CRITERIA SPECIALIST WORKING GROUP RATIONALE FOR ADDITIONS/CLARIFICATIONS Condition Name Pyoderma Gangrenosum Pyoderma Gangrenosum Unchanged Specialty Immunology Immunology Unchanged Category Exceptional circumstances only Exceptional circumstances only Unchanged Specific Conditions Pyoderma Gangrenosum Level of Evidence Insufficient data (). Insufficient data (Category 4a) Unchanged Justification for Evidence Category Ig therapy is regarded as adjuvant treatment and is considered third or fourth line treatment, after alternative therapies have been unsuccessful in achieving improvement or remission. While Ig has been proven to be effective in small case series (Patel et al, 2015 and Cummins et al, 2007) and case reports (Cafardi et al, 2014 and De Zwaan et al, 2009), ideally it is used to enhance the effect of existing treatment, rather than as monotherapy. This section has been drafted following assessment of the literature and consultation with the Australian College of Dermatologists. Indication Severe PG when immunosuppressant and biologic therapy is either ineffective or inappropriate due to unacceptable side effects. Relapse of PG in previously responding patients following a trial off Ig therapy Two indications have been defined; the second to support recommencement of Ig therapy in responding patients that may relapse once treatment has been ceased.
Immunology-Ch7-Pyoderma-Gangrenosum.DOCX