Anakinra for recalcitrant pyoderma gangrenosum: a case series

Pyoderma gangrenosum (PG) is an autoinflammatory neutrophilic dermatosis characterized by rapidly enlarging, painful ulcers. Anakinra is a recombinant interleukin-1 (IL-1) receptor antagonist that blocks the activity of IL-1α and IL-1β by competitively inhibiting IL-1 binding to the IL-1 type I receptor. We present a series of two patients with recalcitrant PG, who had limited therapeutic options due to multiple previous treatment failures and multiple co-morbidities, who obtained 100% healing with anakinra. Compared to conventional first-line therapies for PG, the safety profile of anakinra may be preferable for patients with multiple co-morbidities. Further research is needed to assess the safety and efficacy of anakinra for PG.