In patients with inflammatory bowel disease (IBD), secondary erythema nodosum can present as tender erythematous nodules on the lower extremities. When initial IBD-associated therapy does not achieve resolution of those nodules, a structured next-line approach is needed.
This scenario applies specifically to patients with erythema nodosum arising in the context of inflammatory bowel disease. Caution should be taken with the use of non-steroidal anti-inflammatory drugs in patients with IBD, as these drugs may worsen IBD symptoms.
Thalidomide and cyclosporine A have been used in erythema nodosum associated with IBD. This protocol addresses the situation where those agents have not achieved resolution of tender erythematous nodules on the lower extremities — the primary treatment goal of that line.
For recalcitrant erythema nodosum in this setting, tumor necrosis factor-α inhibitors have been used. The full protocol details which specific agents are involved and how they are sequenced — that information is available via the link below.
The treatment goal is resolution of tender erythematous nodules on the lower extremities.
DOI: 10.1007/s40257-021-00592-w
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