Is speed of healing a good predictor of eventual healing of pyoderma gangrenosum?

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• 作者：Sally R. Wilkes ; PhD^a ; Hywel C. Williams ; DSc^a ; Anthony D. Ormerod ; MD^c ; Fiona E. Craig ; MBBS^e ; Nicola Greenlaw ; MSc^f ; John Norrie ; MSc^d ; Eleanor J. Mitchell ; BA (Hons)^b ; James M. Mason ; PhD^g ; Kim S. Thomas ; PhD^a ; ^{Kim.Thomas@nottingham.ac.uk" class="auth_mail" title="E-mail the corresponding author} ; on behalf of the United Kingdom Dermatology Clinical Trials Network STOP GAP team
• 关键词：clinical practice ; clinical trials ; lesion improvement ; predictors ; pyoderma gangrenosum ; resolution of inflammation ; speed of healing
• 刊名：Journal of the American Academy of Dermatology
• 出版年：2016
• 出版时间：December 2016
• 年：2016
• 卷：75
• 期：6
• 页码：1216-1220.e2
• 全文大小：687 K

文摘

Pyoderma gangrenosum is a rare inflammatory skin condition. Two prospective studies have evaluated treatments for pyoderma gangrenosum using a primary outcome of healing speed at 6 weeks.

c_2">Objective

Using data from both studies we assessed the predictive value of 3 early predictors for healing at 6 months: speed of healing, Investigator Global Assessment (IGA), and resolution of inflammation, recorded at 2 and 6 weeks.

c_3">Methods

Logistic regression models were applied and the effectiveness of the 3 measures was assessed through estimating the positive and negative predictive values and the area under the receiver operating characteristic curve.

c_4">Results

The positive and negative predictive value at 6 weeks were, respectively, 63.5% (95% confidence interval [CI] 52.4%-73.7%) and 74.6% (95% CI 62.5%-84.5%) for speed of healing; 80% (95% CI 68.7%-88.6%) and 74.2% (95% CI 64.1%-82.7%) for IGA; and 72.1% (95% CI 59.9%-82.3%) and 68.1% (95% CI 57.7%-77.3%) for resolution of inflammation. IGA had the best combined positive predictive value, negative predictive value, and area under the receiver operating characteristic curve at 2 and 6 weeks.

c_5">Limitations

We were limited by data available from existing datasets.

c_6">Conclusion

Speed of healing, IGA, and resolution of inflammation were all shown to be good predictors of eventual healing of pyoderma gangrenosum.