Long-term cyclic intravenous iloprost in systemic sclerosis: clinical experience from a single center
The aim of the present study was to retrospectively evaluate response to therapy in 73 patients affected by systemic sclerosis (SSc) who underwent long-term cyclic treatment with intravenous iloprost for peripheral vascular involvement (average duration of treatment 54.12±41.04 months). Seventy-thre...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
PAGEPress Publications
2012-07-01
|
| Series: | Reumatismo |
| Subjects: | |
| Online Access: | http://www.reumatismo.org/index.php/reuma/article/view/521 |
| _version_ | 1818008916203667456 |
|---|---|
| author | A. Di Vita M. Mosca A. D'Ascanio P. Pepe A. Della Rossa S. Casigliani Rabl S. Bombardieri |
| author_facet | A. Di Vita M. Mosca A. D'Ascanio P. Pepe A. Della Rossa S. Casigliani Rabl S. Bombardieri |
| author_sort | A. Di Vita |
| collection | DOAJ |
| description | The aim of the present study was to retrospectively evaluate response to therapy in 73 patients affected by systemic sclerosis (SSc) who underwent long-term cyclic treatment with intravenous iloprost for peripheral vascular involvement (average duration of treatment 54.12±41.04 months). Seventy-three SSc patients were enrolled. Data were collected by reviewing clinical records and by phone or direct interview. Patients underwent a thorough physical examination at the end of follow up. The incidence of severe vascular manifestations was also assessed. Statistical analysis was performed by Wilcoxon’s signed rank test and descriptive statistics using Statview software. In this study cohort, 55 of 73 (75.2%) patients had a history of ischemic digital ulcers (DUs); 28 patients (38.4%) had active DUs at the beginning of treatment. Skin ulcers healed completely in 25 of 28 patients (89.3%) at the end of the first treatment. However, 40 of 55 patients (72.6%) relapsed after an average of 24 months. There was a significant correlation between relapse rate and/or number of ulcers and clinical factors (diffuse subset, changes in results of Allen’s test, NT-pro BNP levels). The annual incidence of pulmonary arterial hypertension (PAH) was 2.34 (95%CI: 0.94-4.83) per 100 person years, the rate of gangrene was 2.7%, and no cases of scleroderma renal crisis were recorded. The incidence of PAH and of digital gangrene was higher than that observed in unselected SSc case series. These data suggest that our patients treated with iloprost have a higher vascular involvement than large case series of unselected SSc patients. A number of clinical factors are correlated to the severity of vascular involvement and could have an impact on the response to therapy. The clinical significance of these findings requires clarification and further investigation is needed. |
| first_indexed | 2024-04-14T05:36:21Z |
| format | Article |
| id | doaj.art-2a4450f457b0444497a4afea7d5a114a |
| institution | Directory Open Access Journal |
| issn | 0048-7449 2240-2683 |
| language | English |
| last_indexed | 2024-04-14T05:36:21Z |
| publishDate | 2012-07-01 |
| publisher | PAGEPress Publications |
| record_format | Article |
| series | Reumatismo |
| spelling | doaj.art-2a4450f457b0444497a4afea7d5a114a2022-12-22T02:09:38ZengPAGEPress PublicationsReumatismo0048-74492240-26832012-07-0164315816510.4081/reumatismo.2012.158Long-term cyclic intravenous iloprost in systemic sclerosis: clinical experience from a single centerA. Di VitaM. MoscaA. D'AscanioP. PepeA. Della RossaS. Casigliani RablS. BombardieriThe aim of the present study was to retrospectively evaluate response to therapy in 73 patients affected by systemic sclerosis (SSc) who underwent long-term cyclic treatment with intravenous iloprost for peripheral vascular involvement (average duration of treatment 54.12±41.04 months). Seventy-three SSc patients were enrolled. Data were collected by reviewing clinical records and by phone or direct interview. Patients underwent a thorough physical examination at the end of follow up. The incidence of severe vascular manifestations was also assessed. Statistical analysis was performed by Wilcoxon’s signed rank test and descriptive statistics using Statview software. In this study cohort, 55 of 73 (75.2%) patients had a history of ischemic digital ulcers (DUs); 28 patients (38.4%) had active DUs at the beginning of treatment. Skin ulcers healed completely in 25 of 28 patients (89.3%) at the end of the first treatment. However, 40 of 55 patients (72.6%) relapsed after an average of 24 months. There was a significant correlation between relapse rate and/or number of ulcers and clinical factors (diffuse subset, changes in results of Allen’s test, NT-pro BNP levels). The annual incidence of pulmonary arterial hypertension (PAH) was 2.34 (95%CI: 0.94-4.83) per 100 person years, the rate of gangrene was 2.7%, and no cases of scleroderma renal crisis were recorded. The incidence of PAH and of digital gangrene was higher than that observed in unselected SSc case series. These data suggest that our patients treated with iloprost have a higher vascular involvement than large case series of unselected SSc patients. A number of clinical factors are correlated to the severity of vascular involvement and could have an impact on the response to therapy. The clinical significance of these findings requires clarification and further investigation is needed.http://www.reumatismo.org/index.php/reuma/article/view/521Systemic sclerosis, ischemic digital ulcers, iloprost. |
| spellingShingle | A. Di Vita M. Mosca A. D'Ascanio P. Pepe A. Della Rossa S. Casigliani Rabl S. Bombardieri Long-term cyclic intravenous iloprost in systemic sclerosis: clinical experience from a single center Reumatismo Systemic sclerosis, ischemic digital ulcers, iloprost. |
| title | Long-term cyclic intravenous iloprost in systemic sclerosis: clinical experience from a single center |
| title_full | Long-term cyclic intravenous iloprost in systemic sclerosis: clinical experience from a single center |
| title_fullStr | Long-term cyclic intravenous iloprost in systemic sclerosis: clinical experience from a single center |
| title_full_unstemmed | Long-term cyclic intravenous iloprost in systemic sclerosis: clinical experience from a single center |
| title_short | Long-term cyclic intravenous iloprost in systemic sclerosis: clinical experience from a single center |
| title_sort | long term cyclic intravenous iloprost in systemic sclerosis clinical experience from a single center |
| topic | Systemic sclerosis, ischemic digital ulcers, iloprost. |
| url | http://www.reumatismo.org/index.php/reuma/article/view/521 |
| work_keys_str_mv | AT adivita longtermcyclicintravenousiloprostinsystemicsclerosisclinicalexperiencefromasinglecenter AT mmosca longtermcyclicintravenousiloprostinsystemicsclerosisclinicalexperiencefromasinglecenter AT adascanio longtermcyclicintravenousiloprostinsystemicsclerosisclinicalexperiencefromasinglecenter AT ppepe longtermcyclicintravenousiloprostinsystemicsclerosisclinicalexperiencefromasinglecenter AT adellarossa longtermcyclicintravenousiloprostinsystemicsclerosisclinicalexperiencefromasinglecenter AT scasiglianirabl longtermcyclicintravenousiloprostinsystemicsclerosisclinicalexperiencefromasinglecenter AT sbombardieri longtermcyclicintravenousiloprostinsystemicsclerosisclinicalexperiencefromasinglecenter |