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

Wilkes, Sally R. and Williams, Hywel C. and Ormerod, Anthony D. and Craig, Fiona E. and Greenlaw, Nicola and Norrie, John and Mitchell, Eleanor and Mason, James M. and Thomas, Kim S. (2016) Is speed of healing a good predictor of eventual healing of pyoderma gangrenosum? Journal of the American Academy of Dermatology, 75 (6). 1216-1220.e2. ISSN 1097-6787

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Abstract

Background: Pyoderma gangrenosum is a rare inflammatory skin condition. The STOPGAP studies compared treatments for pyoderma gangrenosum using a primary outcome of healing speed at 6 weeks.

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

Methods: Logistic regression models were applied and the effectiveness of the three measures was assessed through estimating the positive (PPV) and negative predictive values (NPV) and the area under the receiver operating characteristic curve (AUC).

Results: The PPV and NPV at 6 weeks were 63.5% (95% CI:52.4%, 73.7%) and 74.6% (95% CI:62.5%, 84.5%) respectively for speed of healing; 80% (95% CI:68.7%, 88.6%) and 74.2% (95% CI:64.1%, 2.7%) for IGA; and 72.1% (95% CI:59.9%, 82.3%) and 68.1% (95% CI:57.7%, 77.3%) for resolution of inflammation. Investigator Global Assessment had the best combined PPV, NPV and AUC at 2 and 6 weeks.

Limitations: We were limited by data available from the STOP GAP trial and cohort study.

Conclusion: Speed of healing, Investigator Global Assessment and resolution of inflammation were all shown to be good predictors of eventual healing.

Item Type: Article
Keywords: Pyoderma Gangrenosum, Speed of Healing, Lesion Improvement, Resolution of Inflammation, Predictors, Clinical Trials, Clinical Practice
Schools/Departments: University of Nottingham, UK > Faculty of Medicine and Health Sciences > School of Medicine > Division of Rheumatology, Orthopaedics and Dermatology
University of Nottingham, UK > Faculty of Medicine and Health Sciences > School of Medicine > Units > Clinical Trials Unit
Identification Number: 10.1016/j.jaad.2016.07.049
Depositing User: Eprints, Support
Date Deposited: 28 Jul 2016 13:27
Last Modified: 15 Oct 2017 09:28
URI: http://eprints.nottingham.ac.uk/id/eprint/35520

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