To the Editor:
We sincerely appreciate the thoughtful comments from Drs. Ginsberg and Rosner regarding our recent article on the efficacy of tumor necrosis factor (TNF) inhibitors for refractory leg ulcers in cutaneous polyarteritis nodosa (PAN).1 We are pleased to learn that their previously published experience with infliximab therapy in refractory systemic PAN yielded results consistent with our observations in patients with cutaneous-limited disease.2
Their report, along with ours, highlights the potential therapeutic role of TNF blockade across the spectrum of PAN, from systemic to cutaneous. The convergence of findings from different populations and disease subsets strengthens the rationale for considering biologic therapy in treatment-resistant PAN.
We also agree that further prospective multicenter studies are warranted to define the optimal dosing regimens, duration of therapy, and long-term safety profiles for this rare but challenging disease.
We thank Drs. Ginsberg and Rosner for their valuable contribution to advancing the understanding of biologic therapy in PAN and for their kind comments on our work.
Footnotes
FUNDING
This study received no specific funding from any bodies in the public, commercial, or not-for-profit sectors.
COMPETING INTERESTS
The authors declare no conflicts of interest relevant to this article.
- Copyright © 2026 by the Journal of Rheumatology
