Open AccessAdalimumab treatment leads to reduction of tissue tumor necrosis factor‐alpha correlated with venous leg ulcer improvement: a pilot study
Author(s) -
Fox Joshua D,
BaquerizoNole Katherine L,
Keegan Brian R,
Macquhae Flor,
Escandon Julia,
Espinosa Aliette,
Perez Carmen,
Romanelli Paolo,
Kirsner Robert S
Publication year - 2016
Publication title -
international wound journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.867
H-Index - 63
eISSN - 1742-481X
pISSN - 1742-4801
DOI - 10.1111/iwj.12497
Subject(s) - medicine , venous leg ulcer , adalimumab , refractory (planetary science) , surgery , tumor necrosis factor alpha , gastroenterology , physics , astrobiology
Venous leg ulcers ( VLUs ) have higher tumor necrosis factor‐α ( TNF ‐α) levels compared with normal skin. Refractory VLUs of long duration have higher TNF ‐α levels compared with VLUs of shorter duration. As up to 75% of VLUs fail to heal with standard care, we sought to evaluate the role of anti‐ TNF ‐α therapy for patients with refractory VLUs . Evaluable data were obtained in four of five subjects with recalcitrant VLUs treated with 80 mg of subcutaneous adalimumab at week 0 and with 40 mg at week 2 along with compression therapy and were followed‐up for 6 weeks. Wound biopsies taken at weeks 0 and 4 were stained with anti‐ TNF ‐α antibodies. Average 4‐week percent wound size reduction was 20.5% ± 6.4%. Two patients had wound size reduction more than 25%, and their percent wound size reduction correlated to percent TNF ‐α staining score reductions ( P = 0.02, R 2 = 0.999). VLU TNF ‐α level decrease 4 weeks post‐adalimumab treatment correlated with wound healing.