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Janka-Zires M, Almeda-Valdes P, Uribe-Wiechers AC, Juárez-Comboni SC, López-Gutiérrez J, Escobar-Jiménez JJ, Gómez-Pérez FJ. Topical Administration of Pirfenidone Increases Healing of Chronic Diabetic Foot Ulcers: A Randomized Crossover Study. J Diabetes Res 2016; 2016:7340641. [PMID: 27478849 PMCID: PMC4958428 DOI: 10.1155/2016/7340641] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Accepted: 05/31/2016] [Indexed: 01/08/2023] Open
Abstract
Only 30 percent of chronic diabetic foot ulcers heal after 20 weeks of standard treatment. Pirfenidone is a drug with biological, anti-inflammatory, and antifibrotic effects. The aim of this study was to evaluate the effect of topical pirfenidone added to conventional treatment in noninfected chronic diabetic foot ulcers. This was a randomized crossover study. Group 1 received topical pirfenidone plus conventional treatment for 8 weeks; after this period, they were switched to receive conventional treatment only for 8 more weeks. In group 2, the order of the treatments was the opposite. The end points were complete ulcer healing and size reduction. Final data were obtained from 35 ulcers in 24 patients. Fifty-two percent of ulcers treated with pirfenidone healed before 8 weeks versus 14.3% treated with conventional treatment only (P = 0.025). Between 8 and 16 weeks, 30.8% ulcers that received pirfenidone healed versus 0% with conventional treatment (P = 0.081). By week 8, the reduction in ulcer size was 100% [73-100] with pirfenidone versus 57.5% with conventional treatment [28.9-74] (P = 0.011). By week 16, the reduction was 93% [42.7-100] with pirfenidone and 21.8% [8-77.5] with conventional treatment (P = 0.050). The addition of topical pirfenidone to conventional treatment significantly improves the healing of chronic diabetic noninfected foot ulcers.
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Affiliation(s)
- Marcela Janka-Zires
- Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Endocrinology and Metabolism Department, Vasco de Quiroga 15, Colonia Belisario Domínguez Sección XVI, Tlalpan, 14080 Mexico City, CDMX, Mexico
| | - Paloma Almeda-Valdes
- Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Endocrinology and Metabolism Department, Vasco de Quiroga 15, Colonia Belisario Domínguez Sección XVI, Tlalpan, 14080 Mexico City, CDMX, Mexico
- *Paloma Almeda-Valdes:
| | - Ana Cecilia Uribe-Wiechers
- Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Endocrinology and Metabolism Department, Vasco de Quiroga 15, Colonia Belisario Domínguez Sección XVI, Tlalpan, 14080 Mexico City, CDMX, Mexico
| | - Sonia Citlali Juárez-Comboni
- Grupo Ángeles, Camino a Santa Teresa 1055, Colonia Héroes de Padierna, Magdalena Contreras, 10700 Mexico City, CDMX, Mexico
| | - Joel López-Gutiérrez
- Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Endocrinology and Metabolism Department, Vasco de Quiroga 15, Colonia Belisario Domínguez Sección XVI, Tlalpan, 14080 Mexico City, CDMX, Mexico
| | | | - Francisco J. Gómez-Pérez
- Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Endocrinology and Metabolism Department, Vasco de Quiroga 15, Colonia Belisario Domínguez Sección XVI, Tlalpan, 14080 Mexico City, CDMX, Mexico
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Pérez G, Almeda-Valdés P, Cuevas-Ramos D, Juárez-Comboni SC, Higuera-Calleja J, Gómez-Pérez FJ. [Hypophysitis autoimmune. Case series and literature review]. GAC MED MEX 2013; 149:229-236. [PMID: 23652190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
Autoimmune hypophysitis is a rare condition that must be considered in the differential diagnosis of any pituitary tumor. We present a series of nine patients with clinical and radiologic diagnosis of autoimmune hypophysitis that were admitted to the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ) in Mexico City between 2000-2012. Clinical, biochemical, imaging features (on MRI), treatment, and follow-up are described, and a review on this disease is presented.
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Affiliation(s)
- Guadalupe Pérez
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Departamento de Endocrinología y Metabolismo, México, D.F
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