In patients with moderate‑to‑severe pyoderma gangrenosum, how does oral prednisone compare to oral cyclosporine in achieving clinical remission at 12 weeks

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._