Cutaneous polyarteritis nodosa (cPAN) is a form of medium-sized vessel vasculitis. Despite a disabling and prolonged course, data on treatment efficacy and safety remain scarce.
ObjectivesWe aimed to describe treatment efficacy and safety in patients with cPAN.
MethodsThis was a multicentre retrospective observational study, recording clinical and biological data together with treatments received. The primary outcome was the rate of complete response (CR) at month 3. Secondary outcomes included drug survival, and safety was assessed.
ResultsWe included 68 patients who received a median of 2 therapeutic lines (interquartile range 1-3). Overall, 13/42 (31%) patients achieved CR with colchicine, 4/17 (23%) with dapsone, 11/25 (44%) with glucocorticoids (GCs) alone, 1/9 (11%) with NSAIDs, 11/13 (84%) with GCs+azathioprine (AZA) and 7/15 (47%) with GCs+methotrexate. GCs+AZA had the best drug survival (median duration 29.5 months [IQR 19.5-36.0]). Response at month 3 was decreased with peripheral neurological involvement (odds ratio 0.19 [95% confidence interval 0.03-0.81], p=0.04). Overall, the rate of treatment-related adverse events was 18%, which led to treatment discontinuation in 7% of patients.
LimitationRetrospective study
ConclusionColchicine seems to confer good benefit–risk balance in cPAN without peripheral sensory neuropathy. GCs+AZA seems the best treatment for disease relapse.
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