Stop Gap Trial Results - Treating Pyoderma Gangrenosum

The results of the STOP GAP trial to compare the effectiveness of the two most commonly used tablet treatments for pyoderma gangrenosum have now been published as an open access paper in the BMJ. The BMJ also has an editorial about the implications of the trial.

Pyoderma gangrenosum is a rare skin disease that causes painful, rapidly spreading ulcers on the skin, and can take many months to heal. It is often associated with other conditions such as rheumatoid arthritis or irritable bowel disease.

The STOP GAP trial found no difference between ciclosporin and prednisolone in the speed of healing over 6 weeks and in the median time to healing. In both groups, fewer than 50% of ulcers had healed by 6 months, and almost 30% of participants had a recurrence of their pyoderma gangrenosum after initial healing.

These results are important as they suggest that clinicians can choose to prescribe either ciclosporin or prednisolone for their patients, with the knowledge that they are likely to be of comparable efficacy.

This means that shared treatment decisions can be made on an individual basis—informed by patient preference and the side-effect profiles of the two drugs.

More information about the STOP GAP trial, and a video of a STOP GAP trial participant talking about her experiences of living with pyoderma gangrenosum, can be found on the STOP GAP trial webpage.

Reference:

Ormerod AD, Thomas KS, Craig FE et al. Comparison of the two most commonly used treatments for pyoderma gangrenosum: results of the STOP GAP randomised controlled trial. BMJ 2015; 350: h2958.