(CR-035) Monoclonal antibodies in the management of chronic wounds: A comprehensive Literature Review

Alessandra Michelucci, MD – Department of Dermatology – University of Pisa; Giammarco Granieri, MD – Department of Dermatology – University of Pisa; Cristian Fidanzi, MD – Department of Dermatology – University of Pisa; Giorgia Salvia, MD – Department of Dermatology – University of Pisa; Matteo Bevilacqua, MD – Department of Dermatology – University of Pisa; Valentina Dini, MD, PhD – Department of Dermatology – University of Pisa; Marco Romanelli, MD, PhD – Department of Dermatology – University of Pisa

Introduction: Chronic wounds represent a clinical challenge of considerable complexity, given the articulated pathophysiology underlying their origin (1) and the burden of long-term management with local dressings (2). Monoclonal antibodies (mAbs) are emerging as a novel therapeutic choice in clinical experiences of different difficult wounds management (3,4,5,6), but no data are still available as a comprehensive view of their use in wound care. The goal of our work was then to systematize the use of these drugs in the experience already gained by the scientific community.

Methods: We performed a literature review examining clinical cases of chronic wounds treated with mAbs. Exquisitely inflammatory pathologies with possible ulcerative outcomes, such as hidradenitis suppurativa, were excluded from the analysis.

Results: mAbs were found to be effective in resolving wounds from 16 different etiopathogenesis. The most represented diseases were pyoderma gangrenosum treated with 12 different mAbs, lipoid necrobiosis and cutaneous vasculitis treated with 3 different mAbs. The total number of mAbs analyzed from the literature was 14. Rituximab was effective in 7/16 diseases (43.75%), followed by Tocilizumab used in 4/16 (25%) diseases and Etanercept and Adalimumab, both used for 3/16 ( 18.75%) conditions.

Discussion: mAbs represent a therapeutic opportunity in cases of chronic wounds recalcitrant to standard treatments and specific measures for the single pathology. Due to the complex molecular landscape of wound healing, it is not possible to identify a single target molecule and for this reason the use of mAbs should be interpreted as a translational application to limited cases of multi-resistant conditions.