The Relationship between Autoimmune Disease and Disease Modifying Anti-Rheumatic Drugs on Wound Healing - PubMed

• Updated on: 2022-06-11
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doi: 10.1089/wound.2021.0150. Online ahead of print.
The Relationship between Autoimmune Disease and Disease Modifying Anti-Rheumatic Drugs on Wound Healing
Affiliations
1 Georgetown University School of Medicine, 12230, Washington, District of Columbia, United States; kmk301@georgetown.edu.
2 MedStar Georgetown University Hospital, 71541, Department of Plastic and Reconstructive Surgery, Washington, District of Columbia, United States; PKD15@GEORGETOWN.EDU.
3 Georgetown University School of Medicine, 12230, Washington, District of Columbia, United States; jmk411@georgetown.edu.
4 Georgetown University School of Medicine, 12230, Washington, District of Columbia, United States; sz523@georgetown.edu.
5 MedStar Georgetown University Hospital, 71541, Department of Plastic and Reconstructive Surgery, 3800 Reservoir Rd NW, Washington, District of Columbia, United States, 20007; JCB238@GEORGETOWN.EDu.
6 MedStar Georgetown University Hospital, 71541, Department of Plastic and Reconstructive Surgery, Washington, District of Columbia, United States; aerogers129@gmail.com.
7 MedStar Georgetown University Hospital, 71541, Department of Plastic and Reconstructive Surgery, Washington, District of Columbia, United States; egz3@georgetown.edu.
8 MedStar Georgetown University Hospital, 71541, Department of Plastic and Reconstructive Surgery, Washington, District of Columbia, United States.
9 Georgetown University School of Medicine, 12230, Washington, District of Columbia, United States; Kenneth.L.Fan@medstar.net.
10 Georgetown University School of Medicine, 12230, Washington, District of Columbia, United States; Karen.k.evans@medstar.net.
11 MedStar Georgetown University Hospital, 71541, Department of Dermatology, Washington, District of Columbia, United States.
12 Georgetown University School of Medicine, 12230, Washington, District of Columbia, United States; CarolDeane.Benedict@gunet.georgetown.edu.
13 Georgetown University School of Medicine, 12230, Washington, District of Columbia, United States; Helena.B.Pasieka@medstar.net.
14 Georgetown University School of Medicine, 12230, Washington, District of Columbia, United States; cattinger@aol.com.
PMID: 34714156
The Relationship between Autoimmune Disease and Disease Modifying Anti-Rheumatic Drugs on Wound Healing
Kunal M Kirloskar et al. Adv Wound Care (New Rochelle).
2021
Adv Wound Care (New Rochelle)
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doi: 10.1089/wound.2021.0150. Online ahead of print.
Authors
Affiliations
1 Georgetown University School of Medicine, 12230, Washington, District of Columbia, United States; kmk301@georgetown.edu.
2 MedStar Georgetown University Hospital, 71541, Department of Plastic and Reconstructive Surgery, Washington, District of Columbia, United States; PKD15@GEORGETOWN.EDU.
3 Georgetown University School of Medicine, 12230, Washington, District of Columbia, United States; jmk411@georgetown.edu.
4 Georgetown University School of Medicine, 12230, Washington, District of Columbia, United States; sz523@georgetown.edu.
5 MedStar Georgetown University Hospital, 71541, Department of Plastic and Reconstructive Surgery, 3800 Reservoir Rd NW, Washington, District of Columbia, United States, 20007; JCB238@GEORGETOWN.EDu.
6 MedStar Georgetown University Hospital, 71541, Department of Plastic and Reconstructive Surgery, Washington, District of Columbia, United States; aerogers129@gmail.com.
7 MedStar Georgetown University Hospital, 71541, Department of Plastic and Reconstructive Surgery, Washington, District of Columbia, United States; egz3@georgetown.edu.
8 MedStar Georgetown University Hospital, 71541, Department of Plastic and Reconstructive Surgery, Washington, District of Columbia, United States.
9 Georgetown University School of Medicine, 12230, Washington, District of Columbia, United States; Kenneth.L.Fan@medstar.net.
10 Georgetown University School of Medicine, 12230, Washington, District of Columbia, United States; Karen.k.evans@medstar.net.
11 MedStar Georgetown University Hospital, 71541, Department of Dermatology, Washington, District of Columbia, United States.
12 Georgetown University School of Medicine, 12230, Washington, District of Columbia, United States; CarolDeane.Benedict@gunet.georgetown.edu.
13 Georgetown University School of Medicine, 12230, Washington, District of Columbia, United States; Helena.B.Pasieka@medstar.net.
14 Georgetown University School of Medicine, 12230, Washington, District of Columbia, United States; cattinger@aol.com.
PMID: 34714156
Format
Abstract
Objective: To evaluate the role of disease-modifying anti-rheumatic drugs (DMARDs) on wound healing outcomes of patients with autoimmune disease at our tertiary wound care center.
Approach: Retrospective review of patients presenting to our wound care center between 2014 and 2018 with both chronic wounds and a history of inflammatory disease. Patient demographics, comorbid conditions, and progression to complete wound healing were compared between those taking DMARDs or not at the time of wound onset. The study adheres to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement.
Results: 58 patients with a total of 296 wounds were retrospectively reviewed. Patients were taking at least one DMARD at wound onset in 217 (73.3%) of these wounds. The average number of DMARDs at wound onset was 1.5 (SD 1.2). 210 wounds progressed to heal (70.9%) with a median time to healing of 229.5 days (IQR 71.0-490.0). Of the 210 wounds that healed, patients taking at least one DMARD had a significantly shorter time to healing relative to patients who were not on any DMARDs (median 190.5 vs 340.0 days, p=0.0156).
Innovation: Characterizing wound healing outcomes at a tertiary hospital with a dedicated wound care center and analyzing the role of DMARDs in wound healing progression.
Conclusions: Chronic wounds are notoriously challenging to treat in the setting of autoimmune disease. The median time to healing in the studied cohort was 229.5 days, which is alarming when compared to patients with non-infected diabetic foot ulcers, who take a median time to heal of 30.8 days at our institution.10.